Six-month follow-up after recovery of COVID-19 Delta variant survivors via CT-based deep learning

Jianliang Huang; Ruikai Lin; Na Bai; Zhongrui Su; Mingxin Zhu; Han Li; Conghai Chai; Mingkai Xia; Ziwei Shu; Zhaowen Qiu; Mingsheng Lei

doi:10.3389/fmed.2023.1103559

Six-month follow-up after recovery of COVID-19 Delta variant survivors via CT-based deep learning

Front Med (Lausanne). 2023 Feb 2:10:1103559. doi: 10.3389/fmed.2023.1103559. eCollection 2023.

Authors

Jianliang Huang¹, Ruikai Lin², Na Bai², Zhongrui Su¹, Mingxin Zhu¹, Han Li², Conghai Chai¹, Mingkai Xia¹, Ziwei Shu³, Zhaowen Qiu^{2

4}, Mingsheng Lei^{1

5}

Affiliations

¹ Zhangjiajie Hospital Affiliated to Hunan Normal University, Zhangjiajie, China.
² College of Information and Computer Engineering, Northeast Forestry University, Harbin, China.
³ Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
⁴ Heilongjiang Tuomeng Technology Co., Ltd., Harbin, China.
⁵ Zhangjiajie College, Zhangjiajie, China.

Abstract

Purpose: Using computer-aided diagnosis (CAD) methods to analyze the discharge and 6-month follow-up data of COVID-19 Delta variant survivors, evaluate and summarize the recovery and prognosis, and improve people's awareness of this disease.

Methods: This study collected clinical data, SGRQ questionnaire results, and lung CT scans (at both discharge and 6-month follow-up) from 41 COVID-19 Delta variant survivors. Two senior radiologists evaluated the CT scans before in-depth analysis. Deep lung parenchyma enhancing (DLPE) method was used to accurately segment conventional lesions and sub-visual lesions in CT images, and then quantitatively analyze lung injury and recovery. Patient recovery was also measured using the SGRQ questionnaire. The follow-up examination results from this study were combined with those of the original COVID-19 for further comparison.

Results: The participants include 13 males (31.7%) and 28 females (68.3%), with an average age of 42.2 ± 17.7 years and an average BMI of 25.2 ± 4.4 kg/m². Compared discharged CT and follow-up CT, 48.8% of survivors had pulmonary fibrosis, mainly including irregular lines (34.1%), punctuate calcification (12.2%) and nodules (12.2%). Compared with discharged CT, the ground-glass opacity basically dissipates at follow-up. The mean SGRQ score was 0.041 (0-0.104). The sequelae of survivors mainly included impaired sleep quality (17.1%), memory decline (26.8%), and anxiety (21.9%). After DLPE process, the lesion volume ratio decreased from 0.0018 (0.0003, 0.0353) at discharge to 0.0004 (0, 0.0032) at follow-up, p < 0.05, and the absorption ratio of lesion was 0.7147 (-1.0303, 0.9945).

Conclusion: The ground-glass opacity of survivors had dissipated when they were discharged from hospital, and a little fibrosis was seen in CT after 6-month, mainly manifested as irregular lines, punctuate calcification and nodules. After DLPE and quantitative calculations, we found that the degree of fibrosis in the lungs of most survivors was mild, which basically did not affect lung function. However, there are a small number of patients with unabsorbed or increased fibrosis. Survivors mainly had non-pulmonary sequelae such as impaired sleep quality and memory decline. Pulmonary prognosis of Delta variant patients was better than original COVID-19, with fewer and milder sequelae.

Keywords: COVID-19 sequelae; Delta variant survivors; deep lung parenchyma enhancing; follow-up; pulmonary fibrosis; sub-visual lesion.

Grants and funding

This work was financially supported by the Key R&D project in Heilongjiang Province (No. 2022ZX01A30), the General Program of Natural Science Foundation of Hunan Province of China (No. 2017JJ2261), the Science and Technology Program of Suzhou (Nos. ZXL2021431 and RC2021130), the Zhangjiajie Yongding District Science and Technology Innovation Program Project (2022), and the Fundamental Research Funds for the Central Universities (No. 2572020DR10).