Background Coronavirus disease 2019 (COVID–19) is associated with enlarged luminal areas of large conducting airways. In 10—30% of patients with acute COVID–19 infection, symptoms persist for more than 4 weeks (referred to as post–acute sequelae of COVID–19, or PASC), and it is unknown if airway changes are associated with this persistence. Thus, we aim to investigate if luminal area of large conducting airways is different between PASC and COVID–19 patients, and healthy controls. Methods In this retrospective case–control study seventy–five patients with PASC (48 females) were age–, height–, and sex–matched to 75 individuals with COVID-19 and 75 healthy controls. Using three–dimensional digital reconstruction from computed tomography imaging, we measured luminal areas of seven conducting airways, including trachea, right and left main bronchi, bronchus intermediate, right and left upper lobe, and left lower lobe bronchi. Findings Airway luminal areas between COVID–19 and PASC groups were not different (p>0.66). There were no group differences in airway luminal area (PASC vs control) for trachea and right main bronchus. However, in the remaining five airways, airway luminal areas were 12% to 39% larger among PASC patients compared to controls (p<0.05). Interpretation Patients diagnosed with COVID–19 and PASC have greater airway luminal area in most large conducting airways compared to healthy controls. No differences in luminal area between patients with COVID–19 and PASC suggest persistence of changes or insufficient time for complete reversal of changes. Funding National Heart, Lung, and Blood Institute (F32HL154320 to JWS; 5R35HL139854 to MJJ); Postdoctoral Fellowship from the Natural Sciences and Engineering Research Council of Canada (AHR).

中文翻译：

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COVID-19 和 COVID-19 急性后遗症患者的大传导气道管腔面积增加一项回顾性病例对照研究

背景 2019 年冠状病毒病 (COVID-19) 与大型传导气道管腔面积扩大有关。10-30% 的急性 COVID-19 感染患者的症状持续超过 4 周（称为 COVID-19 急性后遗症或 PASC），目前尚不清楚气道变化是否与这种持续存在相关。因此，我们的目的是调查 PASC 和 COVID-19 患者以及健康对照之间的大传导气道管腔面积是否不同。方法 在这项回顾性病例对照研究中，75 名 PASC 患者（48 名女性）与 75 名 COVID-19 患者和 75 名健康对照者进行了年龄、身高和性别匹配。利用计算机断层扫描成像的三维数字重建，我们测量了七个传导气道的管腔面积，包括气管、左右主支气管、中间支气管、左右上叶和左下叶支气管。研究结果 COVID-19 组和 PASC 组之间的气道管腔面积没有差异 (p>0.66)。气管和右主支气管的气道腔面积（PASC 与对照）没有组间差异。然而，在其余 5 个气道中，PASC 患者的气道管腔面积比对照组大 12% 至 39%（p<0.05）。解释 与健康对照相比，诊断为 COVID-19 和 PASC 的患者在大多数大型传导气道中具有更大的气道管腔面积。COVID-19 和 PASC 患者之间的管腔面积没有差异，表明变化持续存在或没有足够的时间来完全逆转变化。资助国家心肺血液研究所（F32HL154320 至 JWS；5R35HL139854 至 MJJ）；加拿大自然科学与工程研究委员会（AHR）的博士后奖学金。