الفهرس 
Gross Anatomy of the LungsOnly 14 pages are availabe for public view
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Abstract
In December 2019, an outbreak of unexplained pneumonia in Wuhan was caused by a new coronavirus infection named COVID-19 (Corona Virus Disease 2019).
Chest CT scans are emerging as a useful tool in the diagnostic process of viral pneumonia cases associated with COVID-19, Detection of complications, and prognostication of coronavirus disease 2019 (COVID19).
The typical chest CT findings of covid-19 pneumonia are bilateral ground glass opacities with or without consolidation and with lower lobe predilection in all patients.
Progressive fibrotic lung disease is one of the possible consequences of COVID-19 pulmonary pneumonia. The mechanisms through which severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes lung damage are only partly known, but plausible contributors include a cytokine release syndrome triggered by the viral antigen, drug-induced pulmonary toxicity, and high airway pressure and hyperoxia-induced acute lung injury secondary to mechanical ventilation. Pulmonary fibrosis is associated with non-reversible lung dysfunction.
Little is known about the long-term lung radiographic changes in patients who have recovered from (COVID-19), especially those with severe disease, the long-term lung changes should be included in further studies.
CT imaging features such as broncho-vascular distortion, fibrotic bands, traction bronchiectasis and inter-lobar septal thickening are suggestive of pulmonary fibrosis.
Our study aimed to assess the radiographic findings using MDCT in followup to detect the pulmonary fibrosis.
This study included 100 patients who were symptomatic for covid-19 with positive PCR test, 48 were male and52 were female with an age ranging from (18-88) years (The mean age was about 51.17± 17.27 years). This cross-sectional prospective study was carried out at the radiology department, shibin el-kom fever, and chest hospitals during the period from October 2021to October 2022.
In this study chest CT was done at three time points (admission, first follow up after 3 to 4 weeks and second follow up after 12-to 14
Weeks).
The chest CT at time of admission showed unilateral/bilateral patchy areas of GGO of variable CTSS. The first follow showed that (50%) 50 cases developed pulmonary fibrosis in the form of (32% ) 16 case showed fibrotic bands, (30%) 15 case showed crazy paving pattern, (24%) 12 case showed traction bronchiectasis, (10%) 5 cases showed thickened interlobular septae ,and (4%) 2cases showed halo sign. The second follow up which showed that (39%) 39 cases had persistent fibrotic changes, (11%) 11 cases showed resolving of lung fibrotic changes. The fibrotic patterns in the second follow up were, (43.6%)17cases showed fibrotic bands,(20.5%) 8cases showed thickening of the interlobular septae, (15.4%) 6cases showed traction bronchiectasis,(10.4%)4cases showed crazy paving pattern ,and (10,4%) showed broncho-vascular distortion.
In conclusion, the clinical presentation, course, and outcome of COVID-19 are heterogeneous, and this also applies to the degree of pulmonary involvement. we have demonstrated that follow up chest CT has an important role in the detection of post covid-19 pulmonary fibrosis. A significant percentage of recovered COVID-19 patients (39%) appear to have developed pulmonary fibrosis, which may mostly persist over time. Hence, close follow-up of is recommended. Parenchymal bands, interlobular septal thickening, traction bronchiectasis, crazy paving pattern, and broncho-vascular distortion ground-glass opacities were the most common lung abnormalities found in fibrotic patients. More comprehensive longitudinal studies are still required with larger sample sizes.