CTICasesResolving Post-COVID Diffuse Alveolar Damage
Imaging findings
Serial CT scans of a patient post-COVID-19 infection show evolution from the early exudative and organizing phases of diffuse alveolar damage with peri-bronchovascular consolidation and lobular sparing, to a late phase with persistent ground-glass opacities, distortion, and scarring at five months. However, a follow-up CT at one year demonstrates significant resolution of the ground-glass opacities and persistent, but improved, residual parenchymal bands and fibrosis.
Key takeaways
It takes a long time for the lungs to heal following diffuse alveolar damage, such as that caused by severe COVID-19. Radiologists should avoid diagnosing permanent fibrosis too early, as substantial recovery and resolution of ground-glass opacities can occur late in the healing process; patients should be followed for at least six to nine months, or even a year, to assess for true, stable fibrotic changes.
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