Evaluation of Clinical, Laboratory, and Imaging Progression and Prognostic Outcomes in Patients with Post-COVID-19 Pneumonia

Literature Review

Post-COVID pneumonia is a lung injury that develops after the acute phase of COVID-19, which is characterized by slowly regressing respiratory symptoms, radiological changes, and impaired lung function. According to existing studies, after several weeks or months of improvement, a significant proportion of patients continue to complain of fatigue, dry cough, and dyspnea, despite the fact that SARS-CoV-2 PCR is already negative. However, a prolonged increase in neutrophil-lymphocyte imbalance, CRP, and D-dimer indicates a background of chronic low-intensity inflammation, and spirometry is dominated by restrictive ventilation disorders and reduced gas diffusion, which is especially evident in cases of severe COVID-19 or acute respiratory distress syndrome.

Ground-glass infiltration is still relevant on computed tomography against the background of fibrotic changes; its frequency and extent are determined by the severity of the acute phase, the CT severity index, and the duration of hypoxemia. The prognosis in patients with acute respiratory distress syndrome is worse due to higher fibrotic changes and reduced tolerance to physical activity than in mild cases.

An integrated, “triple” assessment is important for the interpretation of the final diagnosis, treatment tactics, and prognosis: a joint analysis of clinical, laboratory, and radiological data - for the purpose of identifying high-risk patients and further monitoring.