{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T08:11:12Z","timestamp":1781511072363,"version":"3.54.1"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,4,3]],"date-time":"2024-04-03T00:00:00Z","timestamp":1712102400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Few studies consider both radiological and functional outcomes in COVID-19 survivors treated in the intensive care unit (ICU). We investigated clinical findings and pulmonary abnormalities on chest computed tomography (CT) and compared outcomes of severe versus mild-moderate acute respiratory distress syndrome (ARDS) on long-term follow-up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This longitudinal cohort study included 118 COVID-19 patients (median age, 58\u2009years; 79% men). Thoracic CT scans were performed 4, 10, and 22\u2009months after hospital discharge. Two independent blinded radiologists analyzed the 10\u2009months scans and scored the radiology findings semi-quantitatively, as no\/minor versus widespread opacities [low-radiology opacity grade (ROG) versus high-ROG]. ARDS severity was based on the PaO2\/FiO2 ratio. The 6\u2009min walk test (6MWT) was performed after 3 and 9\u2009months, and lung diffusion capacity for carbon monoxide (DLCO) and lung volume measurement after 9 and 15\u2009months. Dynamic spirometry was done at all time points. Residual symptoms and health-related quality-of-life (HRQL) were evaluated using validated questionnaires.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At 10\u2009months, most patients (81\/118; 69%) were classified as high-ROG, of which 70% had severe ARDS during hospitalisation; 69% of those with mild-moderate ARDS also had high-ROG. Patients with high-ROG had longer ICU stay and lower PaO2\/FiO2 during hospitalisation (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.01). At 9\u2009months follow-up, patients with high-ROG had smaller lung volumes as % of predicted values [mean (\u00b1CI): 80 (77\u201384) vs. 93 (88\u201398) (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001)], lower DLCO as % of predicted values [74 (70\u201378) vs. 87 (82\u201392) (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001)], lower oxygen saturation during 6MWT (<jats:italic>p<\/jats:italic>\u2009=\u20090.02), and a tendency to more severe dyspnoea (<jats:italic>p<\/jats:italic>\u2009=\u20090.07), but no difference was found in HRQL compared with no\/minor ROG (<jats:italic>p<\/jats:italic>\u2009=\u20090.92). A higher opacity score was related to lower DLCO at follow-up (<jats:italic>r<\/jats:italic>\u2009=\u2009\u22120.48, <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001, Spearman rank test). Severe ARDS patients had slightly more severe fatigue at 9\u2009months compared to mild\u2013moderate, but no differences in dyspnoea or lung function at follow-up. Fibrotic-like changes were found in 93% of patients examined with CT scans at 2\u2009years (55\/118; 47%). Severe ARDS could predict widespread opacities (ROG\u2009&amp;gt;\u200925%) in most patients at follow-up at 10\u2009months (AUC 0.74).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Residual radiological abnormalities in ICU-treated COVID-19 patients, evaluated for up to 2\u2009years, relate to persisting symptoms and impaired lung function, demanding careful follow-up regardless of ARDS severity at hospitalisation.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2024.1263511","type":"journal-article","created":{"date-parts":[[2024,4,3]],"date-time":"2024-04-03T04:40:06Z","timestamp":1712119206000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Residual radiological opacities correlate with disease outcomes in ICU-treated COVID-19"],"prefix":"10.3389","volume":"11","author":[{"given":"Mikael","family":"Bj\u00f6rnson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann 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