Organizing pneumonia in COVID‑19 patients: risk factors and long-term outcomes
Radiological pattern and incidence of organizing pneumonia in COVID‑19 patients
Some patients may develop interstitial lung disease (ILD) because of COVID-19 infection. The most prevalent radiological pattern detected in chest-computed tomography (CT) is organizing pneumonia (OP) characterized by ground glass opacification (GGO), consolidation and septal thickening.
Inflammatory response and risk of fibrosis after COVID-19-related organizing pneumonia
It has been reported that approximately one-third of these OP-like cases present complete radiographic resolution of pulmonary lesions 1–2 months after hospitalization.
In contrast, other patients eventually develop fibrotic-like changes likely related to persistent inflammation, as shown in a post-mortem lung tissue analysis by our group.
Steroid responsiveness of organizing pneumonia and treatment controversies
Given that organizing pneumonia is known to be steroid responsive and is the most common radiological pattern during acute and follow-up scans, much interest has been invested in corticosteroid treatment, although results from previous studies are contradictory.
Study objectives: identifying risk factors and long-term outcomes of OP
The objectives of this study are:
- Identify risk factors for the development of OP pattern during the acute phase of COVID-19 and
- Describe the natural history of OP one-year post-discharge follow-up, including the potential effect of oral corticosteroid treatment.
Prognostic implications and steroid dose impact in organizing pneumonia post-COVID-19
Advanced age, previous respiratory diseases, and elevated C-reactive protein levels on admission are significant risk factors for the development of OP-like pattern in patients hospitalized due to COVID-19, and fibrotic-like changes may persist for a long time.
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.
Authors
Sandra Cuerpo, Fernanda Hernandez‑Gonzalez, Mariana Benegas, Nuria Albacar, Alejandra Lopez‑Giraldo, Inés Cobo, Samara Suarez, Verónica Torres, Adelaido Salazar, Nestor Soler, María Noboa‑Sevilla, Alejandro Frino‑García, Nancy Pérez‑Rodas, Joel Francesqui, Xavier Alsina‑Restoy, Ana María Muñoz Fernández, Nuria Roger, Sergio Prieto, Alexandru Vlagea, Estibaliz Ruiz, Rosa Faner, Joan Albert Barberà, Alex Soriano, Joan Ramon Badia, María Molina‑Molina, Oriol Sibila, Marcelo Sánchez, Alvar Agustí, Judith Garcia‑Aymerich, Jacobo Sellares
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Fecha de publicación
5th July 2025
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