COMPARATIVE ASSESSMENT OF COMPUTED TOMOGRAPHY LUNGS CHANGES IN
PATIENTS WITH SARCOIDOSIS BEFORE AND AFTER COVID-19 INFECTION
Zubarev I.S., Popova E.N., Zubareva I.M., Khodakova E.A., Zisman V.A., Serova N.S.
Sechenov University. Moscow, Russia.
Sarcoidosis is characterized by predominant involvement of the thoracic organs and a variable clinical course, which complicates the assessment of changes in the lung parenchyma and intrathoracic lymph nodes over time. Particular relevance is given to studying the effect of previous pneumotropic viral infections on the CT pattern of the disease, since post-infectious changes may mimic sarcoidosis progression and complicate clinical and radiological interpretation.
Purpose. To conduct a comparative analysis of computed tomography changes in the lung parenchyma and intrathoracic lymph nodes in patients with sarcoidosis before and after COVID-19 infection.
Materials and Methods. A retrospective cross-sectional study was performed, including 32 patients with morphologically confirmed respiratory sarcoidosis who had COVID-19 in 2020–2023. For each patient, paired CT examinations performed before and after coronavirus infection were analyzed. The assessment included quantitative and topographic characterization of lung parenchymal changes, including consolidation, nodules, interstitial and fibrotic changes, architectural distortion, as well as changes in intrathoracic lymph nodes. Comparative analysis was performed using the Wilcoxon test, McNemar test, Pearson’s χ² test, and paired t-test.
Results. Comparison of MSCT images before and after COVID-19 infection revealed an increase in the detection rate of consolidation areas from 31.3% to 37.5%, interstitial changes from 65.6% to 75.0%, and fibrotic changes in the lung parenchyma from 75.0% to 84.4%, with a simultaneous decrease in the prevalence of nodules and intrathoracic lymphadenopathy. According to semiquantitative scoring of lung changes, a statistically significant increase after COVID-19 infection was found in the extent of consolidative changes from 0.91 to 1.19 (p=0.0385) and in fibrosis from 1.88 to 2.16 (p=0.0244), mainly due to involvement of the middle and lower lung zones. No significant differences were obtained for other types of changes. Progression of fibrosis and consolidation was recorded in 34.4% and 25.0% of patients, respectively, and significantly exceeded the frequency of their regression.
Discussion. The obtained data indicate an increase in pathological lung changes in patients with sarcoidosis after COVID-19 infection, accompanied by worsening of the MSCT pattern. After viral infection, there was an increased frequency of consolidative, interstitial, and fibrotic changes, with a decrease in the prevalence of nodules and intrathoracic lymphadenopathy. This may indicate a shift in the pattern of lung involvement from a granulomatous component toward an interstitial-fibrotic component.
Conclusion. The identified CT features of lung involvement in sarcoidosis allow COVID-19 to be considered a risk factor for unfavorable disease dynamics and possible profibrotic effects, supporting the need for more careful MSCT follow-up in this category of patients. The results highlight the prospects for further studying the influence of pneumotropic viral infections on the course of sarcoidosis using dynamic CT monitoring and quantitative assessment of lung parenchymal changes, which may contribute to earlier detection of negative disease dynamics and help refine follow-up strategies for these patient groups.
Keywords: sarcoidosis, COVID-19, computed tomography, interstitial lung diseases, pulmonary interstitial fibrosis, lymphadenopathy, post-COVID changes.
Corresponding author: Zubarev I.S., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript
For citation: Zubarev I.S., Popova E.N., Zubareva I.M., Khodakova E.A., Zisman V.A., Ponomareva L.A., Serova N.S. Comparative assessment of computed tomography lungs changes in patients with sarcoidosis before and after covid-19 infectio. REJR 2026; 16(2):69-81. DOI: 10.21569/2222-7415-2026-16-2-69-81.
Received: 13.06.26 Accepted: 01.08.26