{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:56:07Z","timestamp":1760057767206,"version":"build-2065373602"},"reference-count":22,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,2,22]],"date-time":"2025-02-22T00:00:00Z","timestamp":1740182400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: The pulmonary sequelae of COVID-19 and their evolution are of interest to the scientific community. We aimed to determine the radiological changes at 6 and 12 months after COVID-19 pneumonia, its evolution and its risk factors. Materials and Methods: This retrospective longitudinal study included adults admitted for COVID-19 pneumonia from 1 March 2020 to 30 April 2021 who had a high-resolution computed tomography (HRCT) scan at 6 months and 12 months after hospital discharge. The primary outcome was the appearance of radiological abnormalities on HRCT and the number of lung segments affected by them at 6 and 12 months, while the main explanatory variables were about the disease course, analytical parameters and treatment. Results: This study included n = 108 patients, with a mean age of 64 years. There was a decrease in the percentage of patients presenting parenchymal (93.5% to 88.9%, p &lt; 0.001) and reticular (63% to 62%, p &lt; 0.001) patterns on HRCT at 12 months compared to 6, and an increase in those presenting a fibrotic pattern (62% to 63.9%, p &lt; 0.001). Ground-glass opacities were the most frequent radiological change at 6 and 12 months (91.7% and 87%, respectively). There was a significant reduction in the total number of lung segments with ground-glass opacities (445 to 382, p &lt; 0.001) and consolidation (158 to 136, p = 0.019) and an increase in those with bronchiectasis (66 to 80, p = 0.033) between the two moments. After multivariate analysis, high-flow oxygen therapy (HFOT), highest ferritin levels, hypertension and \u226571 years showed an association with the development of subpleural parenchymal bands, consolidation, bronchiectasis and septal thickening at 6 and 12 months. Conclusions: Parenchymal patterns seem to be more frequent than reticular and fibrotic patterns after COVID-19 pneumonia. The fibrotic pattern was the only one that worsened significantly over time, with bronchiectasis being the only change that increased at 12 months. Older age, hypertension, the need for HFOT, and high levels of ferritin may be directly associated with worse radiological outcomes after COVID-19 pneumonia.<\/jats:p>","DOI":"10.3390\/medicina61030382","type":"journal-article","created":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T10:04:28Z","timestamp":1740391468000},"page":"382","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Presence and Evolution of Radiological Changes at 6 and 12 Months After COVID-19 Pneumonia and Their Risk Factors"],"prefix":"10.3390","volume":"61","author":[{"given":"Celia","family":"Roig-Mart\u00ed","sequence":"first","affiliation":[{"name":"Internal Medicine Department, Castell\u00f3n General University Hospital, 12004 Castell\u00f3n, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1684-5473","authenticated-orcid":false,"given":"Antonio","family":"Navarro-Ballester","sequence":"additional","affiliation":[{"name":"Radiology Department, Castell\u00f3n General University Hospital, 12004 Castell\u00f3n, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda-Pilar","family":"Fern\u00e1ndez-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Radiology Department, Castell\u00f3n General University Hospital, 12004 Castell\u00f3n, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2146-378X","authenticated-orcid":false,"given":"Ignacio","family":"P\u00e9rez-Catal\u00e1n","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Castell\u00f3n General University Hospital, 12004 Castell\u00f3n, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Segura-F\u00e1brega","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Castell\u00f3n General University Hospital, 12004 Castell\u00f3n, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4005-0845","authenticated-orcid":false,"given":"Mar\u00eda","family":"Varea-Villanueva","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Castell\u00f3n General University Hospital, 12004 Castell\u00f3n, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sof\u00eda","family":"Folgado-Escudero","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Castell\u00f3n General University Hospital, 12004 Castell\u00f3n, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4076-0647","authenticated-orcid":false,"given":"Germ\u00e1n","family":"Herrero-Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Castell\u00f3n General University Hospital, 12004 Castell\u00f3n, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Dom\u00ednguez-Bajo","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Castell\u00f3n General University Hospital, 12004 Castell\u00f3n, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergio","family":"Fabra-Juana","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Castell\u00f3n General University Hospital, 12004 Castell\u00f3n, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda-Jos\u00e9","family":"Esteve-Gimeno","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Castell\u00f3n General University Hospital, 12004 Castell\u00f3n, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda-Lid\u00f3n","family":"Mateu-Campos","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Castell\u00f3n General University Hospital, 12004 Castell\u00f3n, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2475-5788","authenticated-orcid":false,"given":"Jorge","family":"Us\u00f3-Blasco","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Castell\u00f3n General University Hospital, 12004 Castell\u00f3n, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6501-9867","authenticated-orcid":false,"given":"Jos\u00e9-Manuel","family":"Ramos-Rinc\u00f3n","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Alicante General University Hospital, 03010 Alicante, Spain"},{"name":"Alicante Institute of Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain"},{"name":"Clinical Medicine Department, Miguel Hern\u00e1ndez University of Elche, 03202 Elche, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,22]]},"reference":[{"key":"ref_1","unstructured":"WHO (2020). COVID-19 Dashboard, World Health Organization. Available online: https:\/\/covid19.who.int\/."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2085","DOI":"10.1007\/s10067-020-05190-5","article-title":"Cytokine storm in COVID-19: Pathogenesis and overview of anti-inflammatory agents used in treatment","volume":"39","author":"Soy","year":"2020","journal-title":"Clin. Rheumatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1757","DOI":"10.1056\/NEJMcp2009249","article-title":"Mild or Moderate COVID-19","volume":"383","author":"Gandhi","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"E177","DOI":"10.1148\/radiol.2021203153","article-title":"Six-month Follow-up Chest CT Findings after Severe COVID-19 Pneumonia","volume":"299","author":"Han","year":"2021","journal-title":"Radiology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1016\/S2213-2600(20)30222-8","article-title":"Pulmonary fibrosis secondary to COVID-19: A call to arms?","volume":"8","author":"Spagnolo","year":"2020","journal-title":"Lancet Respir. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1111\/resp.14311","article-title":"One-year follow-up CT findings in COVID-19 patients: A systematic review and meta-analysis","volume":"27","author":"Watanabe","year":"2022","journal-title":"Respirology"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Liu, M., Lv, F., Huang, Y., and Xiao, K. (2021). Follow-Up Study of the Chest CT Characteristics of COVID-19 Survivors Seven Months After Recovery. Front. Med., 8.","DOI":"10.3389\/fmed.2021.636298"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1186\/s43055-021-00434-z","article-title":"Medium-term chest computed tomography (CT) follow-up of COVID-19 pneumonia patients after recovery to assess the rate of resolution and determine the potential predictors of persistent lung changes","volume":"52","author":"Parry","year":"2021","journal-title":"Egypt. J. Radiol. Nucl. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"109676","DOI":"10.1016\/j.ejrad.2021.109676","article-title":"Post-discharge chest CT findings and pulmonary function tests in severe COVID-19 patients","volume":"138","author":"Balbi","year":"2021","journal-title":"Eur. J. Radiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1184","DOI":"10.3390\/tomography8030097","article-title":"Follow-Up CT Patterns of Residual Lung Abnormalities in Severe COVID-19 Pneumonia Survivors: A Multicenter Retrospective Study","volume":"8","author":"Besutti","year":"2022","journal-title":"Tomography"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2588","DOI":"10.3390\/tomography8050216","article-title":"Structural and Functional Pulmonary Assessment in Severe COVID-19 Survivors at 12 Months after Discharge","volume":"8","author":"Corsi","year":"2022","journal-title":"Tomography"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Eizaguirre, S., Sabater, G., Belda, S., Calder\u00f3n, J.C., Pineda, V., Comas-Cuf\u00ed, M., Bonnin, M., and Orriols, R. (2023). Long-term respiratory consequences of COVID-19 related pneumonia: A cohort study. BMC Pulm. Med., 23.","DOI":"10.1186\/s12890-023-02627-w"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"de Paula, C.B.V., Nagashima, S., Liberalesso, V., Collete, M., da Silva, F.P.G., Oricil, A.G.G., Barbosa, G.S., da Silva, G.V.C., Wiedmer, D.B., and Dezid\u00e9rio, F.d.S. (2021). COVID-19: Immunohistochemical Analysis of TGF-\u03b2 Signaling Pathways in Pulmonary Fibrosis. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23010168"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1016\/j.ijtb.2020.11.003","article-title":"Post COVID-19 pulmonary fibrosis. Is it real threat?","volume":"68","author":"Rai","year":"2021","journal-title":"Indian J. Tuberc."},{"key":"ref_15","first-page":"2011396","article-title":"CT of Postacute Lung Complications of COVID-19","volume":"10","author":"Solomon","year":"2021","journal-title":"Radiology"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Chen, Y., Ding, C., Yu, L., Guo, W., Feng, X., Yu, L., Su, J., Xu, T., Ren, C., and Shi, D. (2021). One-year follow- up of chest CT findings in patients after SARS-CoV-2 infection. BMC Med., 19.","DOI":"10.1186\/s12916-021-02056-8"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"106665","DOI":"10.1016\/j.rmed.2021.106665","article-title":"Health-related quality of life profiles, trajectories, persistent symptoms and pulmonary function one year after ICU discharge in invasively ventilated COVID-19 patients, a prospective follow-up study","volume":"189","author":"Gamberini","year":"2021","journal-title":"Respir. Med."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Roig-Mart\u00ed, C., P\u00e9rez-Catal\u00e1n, I., Varea-Villanueva, M., Folgado-Escudero, S., Navarro-Ballester, A., Fern\u00e1ndez-Garc\u00eda, M.P., Segura-F\u00e1brega, A., Herrero-Rodr\u00edguez, G., Dom\u00ednguez-Bajo, E., and Fabra-Juana, S. (2024). Predictors of the presence of radiological abnormalities 6 months after severe COVID-19 pneumonia. BMC Infect. Dis., 24.","DOI":"10.1186\/s12879-024-09767-2"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/j.medin.2021.04.008","article-title":"Pulmonary toxicity by oxygen and COVID-19","volume":"46","year":"2022","journal-title":"Med Intensiva."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1016\/S2213-2600(20)30225-3","article-title":"Pulmonary fibrosis and COVID-19: The potential role for antifibrotic therapy","volume":"8","author":"George","year":"2020","journal-title":"Lancet Respir. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1007\/s00134-020-06062-x","article-title":"High risk of thrombosis in patients with severe SARS-CoV-2 infection: A multicenter prospective cohort study","volume":"46","author":"Helms","year":"2020","journal-title":"Intensive Care Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1513\/AnnalsATS.202008-1002OC","article-title":"Persistent Post-COVID-19 Interstitial Lung Disease. An Observational Study of Corticosteroid Treatment","volume":"18","author":"Myall","year":"2021","journal-title":"Ann. Am. Thorac. Soc."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/3\/382\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:40:31Z","timestamp":1760028031000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/3\/382"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,22]]},"references-count":22,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["medicina61030382"],"URL":"https:\/\/doi.org\/10.3390\/medicina61030382","relation":{},"ISSN":["1648-9144"],"issn-type":[{"type":"electronic","value":"1648-9144"}],"subject":[],"published":{"date-parts":[[2025,2,22]]}}}