Frequency and presentation of pulmonary fibrosis in covid19

Introduction: COVID19 Is a viral infection that appear in Wuhan city, China in December 2019 as severe pneumonia, that soon became a global and declared by WHO as pandemic in March 2020, COVID caused by a new strain of corona virus therefore it took the name( novel ) nCOVID19. The disease mainly spread by droplet but other mode of transmission are reported. COVID19 usually presented as upper respiratory tract infection that usually resolve spontaneously, but severe disease that involve the lower respiratory tract and other extrapulmonary tissues and systems may occur and this result in many complications that increase mortality. Pulmonary complications are more common and pulmonary fibrosis is the most disabling complication that occur.
Later the term post COVID syndrome or long term COVID appear and it indicate long term COVID sequences such as fatigability, depression, breathlessness on exertion or even at rest that may long term oxygen support. All theses post COVID symptoms and problems most likely secondary to pulmonary fibrosis, so this study discus the underline causes of pulmonary fibrosis in COVID19 patients, its frequency and clinical, laboratories and radiological presentation.
Objectives: This study aim to know the frequency and presentation of pulmonary fibrosis in COVID9.
Methodology: This is prospective, descriptive, hospital based study, done in Port Sudan COVID isolation centre, Port Sudan, Sudan, from June 2021 to September 2021.
Result: 138 COVID19 PCR positive patients were enrolled in this study, 26 (18.8%) of them developed pulmonary fibrosis, from those who developed pulmonary fibrosis 53.8% were male and 46.2% female, 46.2% had comorbidity, inflammatory markers that detected ( C-reactive protein, serum ferritin, lactate dehydrogenase and d. dimer polymerase) were elevated in all patients who developed pulmonary fibrosis, all those patient also has leucocytosis and lymphopenia. Staph aureus, pseudomonas, mychoplasma andcitrobacterferundii were isolated from patients or equipments.
Ground- glass appearance was seen in HRCT chest of all 26 patients (100%) and this was diagnostic criteria, 5 patient(19.2%) showed consolidation, 1 patient (3.8%) had radiological feature of traction bronchiectasis, 1 patient (3.8%) showed reticulonodular infiltration and other 1 patient (3.8%) showed interlobular thickening.
Conclusion: Pulmonary fibrosis occur in about one fifth of COVID19 patients and it result in all COVID19 sequences that appear as post COVID syndrome. Pulmonary fibrosis most probably occur due to cytokine storm that cause idiopathic pulmonary pneumonitis, but other causes such as cryptogenic organizing pneumonia, ARDS, and hypersensitivity pneumonitis may precipitate pulmonary fibrosis in COVID19.