What does early fibrosis in chest CT indicate?

Q. Chest CT showed COVID pneumonia and early fibrosis. Kindly explain.

Answered by
Dr. Muhammad Zubayer Alam
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Dec 25, 2020 and last reviewed on: Jul 12, 2023

Hello doctor,

My husband was discharged from the hospital after COVID-19 treatment. He was admitted to the hospital for six days. When he was admitted, his computed tomography (CT) scan showed COVID pneumonia and early fibrosis. He was on steroid treatment in the hospital and discharged in stable condition. I doubt the mention of early fibrosis. What does it imply, and is it long term consequences? He has diabetes too. I have attached his CT scan report. Kindly advise.



Welcome to icliniq.com. I can understand your concern. According to your statement, you have been suffering from COVID pneumonia. His HRCT (high-resolution chest tomography) of the chest has revealed multiple patchy ground glass in both lungs, predominantly in the periphery with subpleural bands and early fibrosis (attachment removed to protect patient identity). Early fibrosis in HRCT of the chest is indicating the initial temporal changes in the lung due to COVID pneumonia. Hopefully, early fibrosis will be subsided after recovering from COVID pneumonia and becoming COVID-19 negative. Do repeat HRCT of the chest after your recovery from infection, and it will tell everything about your husband's lungs and give guidance for further treatment in the future. In the case of COVID-19 pneumonia, antiviral medications are needed.

Thank you doctor,

Before the repeat of the computed tomography (CT) test, he has developed a very low pulse. It is around 40 most of the time for a few days. What tests should we get? Is it dangerous?



Welcome back to icliniq.com. In bradycardia, your husband's heart beats fewer than 60 times a minute. This abnormally low heart rate can cause the brain and other organs to become oxygen deprived, developing symptoms like fainting, dizziness, etc. He should undergo ECG (electrocardiography), Echo, etc., to assess his heart condition. Bradycardia may result from various health conditions. But I think your husband's bradycardia may result from COVID-19 or as complications or consequences of COVID-19. His past history of heart diseases, thyroid abnormalities, using medications, etc., are needed to reach a diagnosis. I hope this helps.

Thank you doctor,

I am attaching my echo report.



Welcome back to icliniq.com. According to his echo report (attachment removed to protect patient identity), LV ejection fraction 55% (55-80), which is at the lower limit of normal. An LVEF (left ventricular ejection fraction) means 55% of the total amount of blood in the left ventricle is pumped out with each heartbeat. His ejection fraction can go up and down, depends on his heart condition and treatment. By exercising regularly, reducing weight, lowering stress, avoiding alcohol consumption, smoking, salt mixed foods, etc., may help increase his EF (ejection fraction) levels and pulse rate. In other words, making him active in work will help to raise his pulse rate. If his low pulse rate or bradycardia persists for a long, he should consult a cardiologist to adjust the medication to raise his pulse rate.

Thank you doctor,

There are one or two more findings like left ventricular hypertrophy (LVH) present etc. Can you elaborate on that?



Welcome back to icliniq.com. The interventricular septum is the wall that separates the two ventricles of the heart from one another. Normal limits are 6-12, but your husband has 14, which is slightly above the normal that means slight thickening of the interventricular septum or interventricular septal hypertrophy (mild). Interventricular septal hypertrophy means when heart muscle cells enlarge and cause lower heart chambers walls, mostly the left ventricle, to thick. Again his posterior muscle thickness is 11, and the normal range is 5-10. Suppose such type of thickening of heart muscle persists. In that case, that can make it harder for the blood to leave the heart, forcing the heart to work harder to pump blood and decline ejection fraction and eventually develop heart diseases like hypertrophic cardiomyopathy, heart failure, etc. Do not be worried at all. Your husband's heart status is still good now. Restriction of salty foods, fatty foods, and regular exercise will help him prevent future complications. I hope this helps.

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