Organizing pneumonia in hospitalized COVID-19 patients: risk factors and long-term outcomes

Abstract

Background Some patients develop post-COVID-19 organizing pneumonia (OP) that is responsive to corticosteroid treatment. This multicenter, case-control study of patients hospitalized for COVID-19 sought to determine the prevalence, risk factors, radiological outcomes, and evolution after treatment. Methods We included 153 consecutive patients with OP and 140 without OP who required hospitalization because of COVID-19 from February to April 2020. OP patients were followed up for 12 months, with visits at 1, 3, 6, and 12 months after hospital discharge. Results Risk factors for OP at hospital admission were advanced age, previous respiratory disease, and elevated C-reactive protein levels. Follow-up computed thoracic (CT) scans performed one year after admission showed progressive improvement in radiological involvement; however, up to 57% of patients with OP remained with fibrotic-like changes. Multivariate analysis showed a significant association of fibrotic pattern with older age, high dose of corticosteroids, and extensive parenchymal lung involvement on admission CT scans. Conclusions Following COVID-19 OP, fibrotic-like changes may persist over the long term. Higher dose of corticosteroids does not seem to be associated with a better prognosis.