Vanishing lungs - a case report

Efst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn55 ára kona með iktsýki var endurtekið lögð inn á Landspítalann vegna hita, mæði og takverks. Blóðprufur sýndu eðlileg hvít blóðkorn en hækkað CRP og sökk. Ræktanir reyndust neikvæðar. Myndrannsóknir af lungum sýndu þindarhástöðu, lungnavanþenslu (atelectasis) og fleiðruvökva beggja vegna en eðlilegan lungnavef. Öndunarpróf sýndu herpumynd. Anti-dsDNA og anti-Ro/SSA mótefni mældust hækkuð. Vaknaði grunur um heilkenni hverfandi lungna og lyfjaorsakaða rauða úlfa í kjölfar infliximabs. Sjúklingur fékk sterameðferð með góðum árangri, en versnaði jafnharðan aftur. Sjúklingur sýndi mikil batamerki eftir rituximab meðferð. Hér er tilfellinu lýst og greint frá sjaldgæfu birtingarformi rauðra úlfa sem ekki hefur verið lýst á Íslandi áður.A 55 year old female with rheumatoid arthritis who was repeatedly admitted to internal medicine for fever, shortness of breath and pleuritic chest pain. Laboratory work up showed normal WBC but elevated CRP and sedimentatation rate. Cultures were negative. Imaging studies revealed elevated diaphragms, bilateral atelectasis and pleural fluid but normal lung parenchyma. Lung function testing showed restriction. Anti-dsDNA and anti-Ro/SSA were elevated. A clinical diagnosis of anti-TNF-induced lupus secondary to infliximab and shrinking lung syndrome was made. The patient showed improvement on steroids but subsequent worsening when tapered. Rituximab was then initiated with good results

Lung Transplantation in Icelanders

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files. This article is open access.Inngangur: Lungnaígræðsla er valkostur við meðferð á langt gengnum lungnasjúkdómum, öðrum en krabbameinum, þegar lífslíkur eru mjög skertar og lífsgæði léleg, þrátt fyrir bestu mögulegu meðferð. Í flestum tilvikum batna lungnapróf og heilsutengd lífsgæði mikið við lungnaígræðslu. Sýkingar og stíflumyndandi berkjungabólga, einnig kallað langvinn höfnun, eru algengustu fylgikvillarnir eftir lungnaígræðslu. Efniviður og aðferðir: Hér er sagt frá íslenskum sjúklingum sem farið hafa í lungnaígræðslu frá febrúar 1988 til janúar 2015. Gagnagrunnur var unninn afturskyggnt úr sjúkraskrám. Safnað var upplýsingum um bakgrunn sjúklinga, ígræðsluaðgerð, ónæmisbælingu og hafnanir, fylgikvilla og lifun. Niðurstöður: Alls hefur verið gerð 21 lungnaígræðsla á 20 einstaklingum en einn sjúklingur hefur tvisvar farið í aðgerð. Um var að ræða 9 konur og 11 karla og meðalaldur við ígræðslu var 45 ár (20-61 ár). Flestar aðgerðirnar hafa verið gerðar á Sahlgrenska-sjúkrahúsinu í Gautaborg. Flestir fengu ígrædd bæði lungu. Langvinn lungnateppa var algengasta ábendingin. Algengustu fylgikvillar eftir lungnaígræðslu voru hafnanir og sýkingar. Átta af 20 sjúklingum hafa fengið bráðahöfnun og helmingur sjúklinga langvinna höfnun. Alls eru 6 af 20 sjúklingum látnir, af þeim létust þrír vegna langvinnrar höfnunar á ígræddu líffæri. Miðgildi lifunar er 8,5 ár. Fimm ára lifun er 74%. Ályktanir: Lungnaígræðslur á Íslendingum eru nú framkvæmdar á Sahlgrenskasjúkrahúsinu í Gautaborg en eftirfylgni er á vegum sérhæfðra lungnalækna á Landspítala. Fylgikvillar og lifun íslenskra sjúklinga er sambærilegt við það sem gerist á stærri stofnunum. Náin samskipti og samstarf við stofnunina þar sem ígræðsla fer fram er lykilatriði.Introduction: Lung transplantation is a treatment option for end-stage lung diseases, excluding lung cancer, when life expectancy is short and quality of life is poor. In most instances pulmonary function and quality of life improves after lung transplantation. Infections and rejection are the most common complications and limit the feasibility of lung transplantation. Materials and methods: Retrospective analysis of lung transplantations performed on Icelanders from February 1988 to January 2015. Clinical information was obtained from medical records and a database was created. Information on demographics, underlying lung disease, type of transplantation, immunosuppression, rejection and other complications was collected. Results: A total of 21 lung transplantations were performed, one of which was a retransplantation. There were 9 females and 11 males and the mean age was 45 years (20-61 years). Most of the operations were done at the Sahlgrenska hospital in Gothenburg. Bilateral lung transplantion was the most common operation. COPD was the most common indication. Rejection and infections were the most common complications. Eight of 20 patients have had acute rejection and half of the patients chronic rejection. Six of 20 patients are deceased, three died from chronic rejection. Median survival is 8,5 years. Five-year survival is 74%. Conclusions: Lung transplantations are currently performed at the Sahlgrenska hospital in Gothenburg but follow-up is in the hands of specialized pulmonologists in Iceland. Complications and survival for Icelandic patients is similar to larger centers. Close cooperation with the transplanting center is essential

Respiratory function and CT abnormalities among survivors of COVID-19 pneumonia : a nationwide follow-up study

Publisher Copyright: © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.INTRODUCTION: Considering the pulmonary burden caused by acute COVID-19, questions remain of respiratory consequences after recovery. The aim of the study was to describe respiratory function of COVID-19 pneumonia survivors at mid-term follow-up (median 68 days) and assess whether impairments were predicted by acute illness severity or residual CT abnormalities. METHODS: Residents of Iceland that had COVID-19 and oxygen saturation ≤94% from 28 February 2020 to 30 April 2021 were offered a clinical follow-up visit with an interview, a 6 min walk test (6MWT), spirometry with gas exchange measurement and chest CT. The results of these examinations were described, grouped by the level of care during acute illness. The associations of disease severity and CT abnormalities at follow-up with subjective dyspnoea, 6MWT results and lung function test results were estimated with regression analyses. RESULTS: Of 190 eligible patients, 164 (86%) participated in the study. Of those, 32 had never been admitted to hospital, 103 were admitted to hospital without intensive care and 29 had required intensive care. At a follow-up, need for intensive care during acute illness was associated with shorter walking distance on 6MWT, lower oxygen saturation and lower DLCO. Imaging abnormalities at follow-up were observed for most participants (74%) and the magnitude of these changes was associated with decrements in 6MWT distance, oxygen saturation, forced vital capacity and DLCO. CONCLUSIONS: The findings show that impaired exercise capacity and lung physiology at follow-up were primarily observed for patients with COVID-19 pneumonia that required intensive care treatment and/or had persistent imaging abnormalities.Peer reviewe

Development of a prognostic model of COVID-19 severity : a population-based cohort study in Iceland

© 2022. The Author(s).BACKGROUND: The severity of SARS-CoV-2 infection varies from asymptomatic state to severe respiratory failure and the clinical course is difficult to predict. The aim of the study was to develop a prognostic model to predict the severity of COVID-19 in unvaccinated adults at the time of diagnosis. METHODS: All SARS-CoV-2-positive adults in Iceland were prospectively enrolled into a telehealth service at diagnosis. A multivariable proportional-odds logistic regression model was derived from information obtained during the enrollment interview of those diagnosed between February 27 and December 31, 2020 who met the inclusion criteria. Outcomes were defined on an ordinal scale: (1) no need for escalation of care during follow-up; (2) need for urgent care visit; (3) hospitalization; and (4) admission to intensive care unit (ICU) or death. Missing data were multiply imputed using chained equations and the model was internally validated using bootstrapping techniques. Decision curve analysis was performed. RESULTS: The prognostic model was derived from 4756 SARS-CoV-2-positive persons. In total, 375 (7.9%) only required urgent care visits, 188 (4.0%) were hospitalized and 50 (1.1%) were either admitted to ICU or died due to complications of COVID-19. The model included age, sex, body mass index (BMI), current smoking, underlying conditions, and symptoms and clinical severity score at enrollment. On internal validation, the optimism-corrected Nagelkerke's R2 was 23.4% (95%CI, 22.7-24.2), the C-statistic was 0.793 (95%CI, 0.789-0.797) and the calibration slope was 0.97 (95%CI, 0.96-0.98). Outcome-specific indices were for urgent care visit or worse (calibration intercept -0.04 [95%CI, -0.06 to -0.02], Emax 0.014 [95%CI, 0.008-0.020]), hospitalization or worse (calibration intercept -0.06 [95%CI, -0.12 to -0.03], Emax 0.018 [95%CI, 0.010-0.027]), and ICU admission or death (calibration intercept -0.10 [95%CI, -0.15 to -0.04] and Emax 0.027 [95%CI, 0.013-0.041]). CONCLUSION: Our prognostic model can accurately predict the later need for urgent outpatient evaluation, hospitalization, and ICU admission and death among unvaccinated SARS-CoV-2-positive adults in the general population at the time of diagnosis, using information obtained by telephone interview.Peer reviewe

Illness severity and risk of mental morbidities among patients recovering from COVID-19: a cross-sectional study in the Icelandic population.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadObjective: To test if patients recovering from COVID-19 are at increased risk of mental morbidities and to what extent such risk is exacerbated by illness severity. Design: Population-based cross-sectional study. Setting: Iceland. Participants: A total of 22 861 individuals were recruited through invitations to existing nationwide cohorts and a social media campaign from 24 April to 22 July 2020, of which 373 were patients recovering from COVID-19. Main outcome measures: Symptoms of depression (Patient Health Questionnaire), anxiety (General Anxiety Disorder Scale) and posttraumatic stress disorder (PTSD; modified Primary Care PTSD Screen for DSM-5) above screening thresholds. Adjusting for multiple covariates and comorbidities, multivariable Poisson regression was used to assess the association between COVID-19 severity and mental morbidities. Results: Compared with individuals without a diagnosis of COVID-19, patients recovering from COVID-19 had increased risk of depression (22.1% vs 16.2%; adjusted relative risk (aRR) 1.48, 95% CI 1.20 to 1.82) and PTSD (19.5% vs 15.6%; aRR 1.38, 95% CI 1.09 to 1.75) but not anxiety (13.1% vs 11.3%; aRR 1.24, 95% CI 0.93 to 1.64). Elevated relative risks were limited to patients recovering from COVID-19 that were 40 years or older and were particularly high among individuals with university education. Among patients recovering from COVID-19, symptoms of depression were particularly common among those in the highest, compared with the lowest tertile of influenza-like symptom burden (47.1% vs 5.8%; aRR 6.42, 95% CI 2.77 to 14.87), among patients confined to bed for 7 days or longer compared with those never confined to bed (33.3% vs 10.9%; aRR 3.67, 95% CI 1.97 to 6.86) and among patients hospitalised for COVID-19 compared with those never admitted to hospital (48.1% vs 19.9%; aRR 2.72, 95% CI 1.67 to 4.44). Conclusions: Severe disease course is associated with increased risk of depression and PTSD among patients recovering from COVID-19. Keywords: COVID-19; epidemiology; mental health; public health.Icelandic government NordFors

Áhrif D-vítamíns og reykinga á ósérhæfða ónæmissvörun í lungum

Emerging understanding of vitamin D physiology indicates that vitamin D has a wide variety of functions in addition to being important for bone health. Vitamin D modulates both innate and adaptive immune responses. Low vitamin D levels have been associated with respiratory tract infections and inflammatory lung diseases such as asthma. Cigarette smoking on the other hand is known to adversely affect lung health and predispose individuals to a variety of lung diseases and infections. The primary goal of this thesis is to examine the role of vitamin D (metabolism and immune effects) in respiratory epithelium. In particular, this project addresses vitamin D influences on lung host defense, with focus on virus infections. The secondary goal is to investigate the effects of cigarette smoke on vitamin D metabolism in respiratory epithelium and on function of alveolar macrophages with focus on the autophagy process. All experiments on respiratory epithelium were done on primary human tracheobronchial epithelial cells from cadaveric donors. Respiratory Syncytial Virus (RSV) was used for the virus model. Human alveolar macrophages were obtained by bronchoscopy on healthy smoking or non-smoking volunteers. We show that respiratory epithelial cells have the capacity to convert vitamin D from 25-hydroxyvitamin D3 (storage form) to 1,25-dihydroxyvitamin D3 (active form) and that more 1,25D can be generated when an epithelial cell is infected with a virus. Vitamin D differentially modulates how airway epithelium responds to RSV so that there is an increase in the antimicrobial peptide cathelicidin but decrease in inflammatory chemokines and cytokines. We did not find any differences in viral load. Controlling the inflammatory response to RSV viral infection, while maintaining antiviral activity, may result in decreased disease severity and consequently in decreased morbidity and mortality from RSV infection and possibly other respiratory viruses. Vitamin D is safe, cheap, easily available, and may prove to be an effective therapeutic strategy against respiratory viral infections. In addition we present preliminary results that suggest that cigarette smoke may decrease generation of 1,25D locally in the lungs. Lastly we describe a novel defect in autophagy in alveolar macrophages in smokers which may contribute to increased susceptibility to infections in this population. To summarize, we have shown that both vitamin D and cigarette smoke modulate innate immune responses in the lungs. The vitamin D effects can enhance host defense and dampen the inflammatory response. Cigarette smoking on the other hand increases susceptibility to respiratory infections.Auking þekking á lífeðlisfræði D-vítamíns hefur leitt í ljós að D-vítamín er ekki eingöngu mikilvægt fyrir beinheilsu heldur gegnir það mörgum öðrum hlutverkum. D-vítamín hefur áhrif á bæði ósérhæfða og sérhæfða ónæmissvörun. Faraldsfræðilegar rannsóknir benda til þess að skortur á D-vítamíni tengist aukinni tíðni á sýkingum í öndunarvegi og bólgusjúkdómum í lungum t.d. astma. Reykingar hafa einnig slæm áhrif á lungu og auka líkur á ýmsum lungnasjúkdómum og sýkingum. Aðalmarkmið þessa verkefnis var að skoða umbrot D-vítamíns í lungnaþekjufrumum og hvernig D-vítamín hefur áhrif á ónæmissvörun í lungum. Sérstök áhersla er lögð á áhrif D-vítamíns á viðbrögð lungnaþekjufruma við veirusýkingum. Að auki voru skoðuð áhrif reykinga á umbrot D-vítamíns í lungaþekjufrumum og jafnframt áhrif reykinga á sjálfsát stórátfruma í lungum. Allar tilraunir a lungnaþekjufrumum voru gerðar á ‘primary’ frumum frá efri öndunarvegum manna. Til að kanna áhrif veira notuðum við Respiratory Syncytial Veiru (RSV). Stórátfrumur voru fengnar með berkjuspeglun á sjálfboðaliðum sem reyktu eða höfðu aldrei reykt. Þessar rannsóknir sýna fram á að lungnaþekjufrumur geta umbreytt 25-hydroxyvítamíni D3 (geymslu form) í 1,25-díhydroxyvítamín D3 (virkt form) og jafnframt að veirusýking leiðir til aukinnar myndunar á 1,25D. D-vítamín hefur áhrif á hvernig lungnaþekjufrumur bregðast við RSV sýkingu og eykur myndun á örverudrepandi efnum en minnkar framleiðslu flakkboða og frumuboða. Enginn munur var á fjölda veira í frumuræktunum sem höfðu verið meðhöndlaðar með D-vítamíni og frumuræktunum þar sem ekkert D-vítamín var til staðar. Vægari bólgusvörun og óbreytt magn veiru, gæti dregið úr einkennum og jafnvel haft áhrif á dánartíðni RSV sýkinga og hugsanlega annarra veirusýkinga. D-vítamín hefur fáar aukaverkanir, er ódýrt og auðvelt að nálgast og gæti reynst hjálplegt við meðferð veirusýkinga í öndunarfærum. Jafnframt eru sýndar frumniðurstöður sem gefa til kynna að sígarettureykur getur minnkað myndun á 1,25D í lungum. Að lokum er lýst galla á sjálfsáti í átfrumum frá reykingarmönnum samanborið við einstaklinga sem aldrei hafa reykt. Galli í sjálfsáti getur stuðlað að aukinni hættu á lungnasýkingum í einstaklingum sem reykja. Samantekið, þá sýna þessar rannsóknir fram á að D-vítamín og reykingar hafa áhrif á ósérhæfða ónæmissvörun í lungum. D-vítamín getur eflt ónæmisvarnir og dregið úr bólgusvörun. Reykingar geta aftur á móti aukið næmi fyrir sýkingum í lungum.National Institute of Health University of IowaÁn birtra greina

The impact of lung diseases, smoking and e-cigarette use on the severity of COVID-19 illness at diagnosis

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadINNGANGUR Heimsfaraldur COVID-19-sjúkdóms af völdum SARS-CoV-2 hefur valdið miklu álagi á heilbrigðiskerfi um allan heim og aðgerðir vegna hans valdið miklu efnahagstjóni. Alvarlegum sjúkdómi fylgir yfirleitt lungnabólga og fylgikvillar frá lungum eru algengir í alvarlega veikum sjúklingum. Tengsl lungnasjúkdóma, reykinga og rafrettunotkunar við algengi og alvarleika COVID-19-sjúkdóms eru óljós. EFNIVIÐUR OG AÐFERÐIR Notuð voru gögn úr fyrstu viðtölum á COVID-19-göngudeild Landspítala við 1761 sjúkling með COVID-19 sem fylgt var eftir af spítalanum. Reiknuð var tíðni reykinga, rafrettunotkunar og undirliggjandi lungnasjúkdóma í þessum hópi, eftir aldursflokkum og klínískri flokkun lækna á alvarleika sjúkdómseinkenna. Kannað var hvort munur væri á tíðni þessara áhættuþátta milli aldurshópa og milli einkennaflokka. NIÐURSTÖÐUR Flestir sjúklingar voru á aldrinum 35-54 ára og langflestir höfðu vægan sjúkdóm við greiningu. Tíðni reykinga var um 6%, hæst í aldurshópi 35-54 ára. Rafrettunotendur voru 4%, flestir 18-34 ára. Ekki var munur á tíðni reykinga eða rafrettunotkunar eftir alvarleika einkenna. Lungnasjúkdóm höfðu 9% sjúklinga, fleiri með hækkandi aldri og sjúklingar með alvarlegan COVID-19-sjúkdóm höfðu oftar lungnasjúkdóm en þeir sem höfðu vægari sjúkdóm. ÁLYKTUN Hér er því lýst aldursdreifingu og áhættuþáttum lungnasjúkdóma í samhengi við alvarleika einkenna hjá öllum COVID-19 sjúklingum á Íslandi. Hópurinn er yngri og tíðni alvarlegra einkenna lægri en í mörgum rannsóknum um COVID-19. Athyglisvert er að tíðni reykinga og rafrettunotkunar er heldur lægri en lýst hefur verið í almennu íslensku þýði sem og að tengsl fundust ekki milli þessara þátta og alvarlegs COVID-19-sjúkdóms við greiningu. Niðurstöðurnar sýna því ekki fram á aukið algengi eða alvarleika COVID-19-sjúkdóms meðal notenda reyktóbaks eða rafrettna en benda til tengsla lungnasjúkdóma við alvarlegri einkenni.INTRODUCTION: The COVID-19 pandemic has caused public health and economic turmoil across the globe. Severe COVID-19 disease most often presents with pneumonia and complications in acutely ill patients often stem from the lungs. The associations of lung disease, smoking and e-cigarette use with the incidence and severity of COVID-19 are unclear on a population level. METHODS: Data on 1761 patients from the Icelandic outpatient Landspitali COVID-19 Clinic were used. The prevalence of smoking, e-cigarette use and underlying lung diseases was calculated in the cohort, with stratification based on age groups and a clinical classification of symptom severity. It was tested whether these prevalences differed between age groups and classes of symptom severity. RESULTS: Most patients were in the age group between 35-54 years of age and a large majority had mild symptoms at diagnosis. The prevalence of smoking was 6% with the highest prevalence among 35-54 year olds. The prevalence of e-cigarette use was 4%. It was most prevalent in the age group between 18-34 years. There was no difference in the prevalence of smoking or e-cigarette use between classes of symptom severity. The prevalence of lung disease was 9%. It was higher among older patients and patients with more severe symptoms. CONCLUSION: The age distribution and prevalence of lung disease and their risk factors are described in the context of COVID-19 incidence and symptom severity in a whole-nation cohort of Icelanders. The cohort is younger and had less severe symptoms than in many previosly published studies of COVID-19. Interestingly, the prevalences of smoking and e-cigarette use were lower than in the Icelandic general population and they were not associated with symptom severity at diagnosis. To conclude, the results presented here indicate that underlying lung diseases are prevalent among people with severe COVID-19 symptoms but fail to demonstrate an association between cigarette smoking or e-cigarette smoking with COVID-19 severity

Parenchymal lung changes on CT in patients with coronavirus disease 2019 (COVID-19)

Introduction Infections due to COVID-19 can lead to life threatening pneumonia. Accompanying severe disease are more prominent pulmonary changes on Computed Tomography (CT) scan of the chest. The goal of this study was to describe pulmonary CT changes during acute COVID-19 and at follow up and whether the extent of changes correlate with severity of illness, demographics or other risk factors. Materials and methods Included in this study are all individuals that had confirmed COVID-19 and came for a follow up CT of the chest at Landspitali from May to September 2020. Information regarding medical history was obtained retrospectively from medical charts. All CT scans were reviewed using an international staging system to evaluate the extent of lung changes. Results Eighty-five patients with a mean age of 59 years were included in the study. Sixty patients (71%) were hospitalized during the acute phase and 18 (21%) were admitted to the ICU. During the acute phase more pronounced lung involvement was seen in males and patients admitted to the ICU. At follow-up females had less lung involvement but there was a significant relationship between a higher CT score and age, ICU admissions and days in the ICU. Full recovery was seen at follow-up CT in 31% of patients (median 68,5 days between acute and follow-up imaging). Conclusion Patients with severe COVID-19 have more pronounced lung involvement on CT than patients with milder disease during the acute phase and follow-up. Older patients and males are at greater risk of acute and persistent COVID-19 related lung changes.Peer reviewe

Parenchymal lung changes on CT in patients with coronavirus disease 2019 (COVID-19)

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadINNGANGUR Sýking af völdum kórónuveiru sem veldur kórónuveirusjúkdómi 2019 (COVID-19) getur leitt til lungnabólgu sem í sumum tilvikum er lífshættuleg eða jafnvel banvæn. Þekkt er að þeir sem fá alvarlegri sjúkdóm hafa meiri breytingar í lungnavef á tölvusneiðmyndum (TS) af brjóstholi. Tilgangur rannsóknarinnar var að lýsa myndbreytingum í lungum í bráðafasa COVID-19 og í eftirliti og um leið að meta hvort umfang lungnabreytinga á TS hefði tengsl við alvarleika sjúkdómsins, bakgrunnsþætti og fyrra heilsufar. EFNIVIÐUR OG AÐFERÐIR Rannsóknin náði til allra einstaklinga með staðfest COVID-19 sem komu í eftirlit á göngudeild og fóru í TS eftirlitsrannsókn af brjóstholi á Landspítala frá 6. maí 2020 til 24. september 2020. Upplýsingar um sjúkrasögu sjúklinga voru fengnar úr gagnagrunni Landspítala á afturskyggnan máta. Allar tölvusneiðmyndir voru endurskoðaðar og notað var við alþjóðlegt stigunarkerfi til að meta umfang lungnabreytinga. NIÐURSTÖÐUR Alls voru 85 þátttakendur í rannsókninni, meðalaldur var 59 ár og karlar í meirihluta (52%). Sextíu (71%) lögðust inn á sjúkrahús, þar af 18 (21%) á gjörgæslu. Útbreiddari lungnabreytingar sáust oftar hjá karlmönnum og sjúklingum sem voru inniliggjandi á gjörgæslu. Jafnframt voru þeir líklegri til að þurfa öndunarvélameðferð. Í eftirliti sáust marktæk tengsl færri TS-stiga við kvenkyn en marktæk tengsl fleiri TS-stiga voru við hækkandi aldur, gjörgæslulegu og lengd gjörgæslulegu. Lungnabreytingar voru horfnar hjá tæplega þriðjungi þátttakenda við eftirlit (að miðgildi 68,5 dögum eftir bráðarannsókn). ÁLYKTUN Einstaklingar með alvarlegan COVID-19 hafa umfangsmeiri lungnabreytingar í bráðum veikindum og við eftirlit en þeir sem fá vægari sjúkdóm. Eldri einstaklingar og karlmenn eru í aukinni áhættu.INTRODUCTION Infections due to COVID-19 can lead to life threatening pneumonia. Accompanying severe disease are more prominent pulmonary changes on Computed Tomography (CT) scan of the chest. The goal of this study was to describe pulmonary CT changes during acute COVID-19 and at follow up and whether the extent of changes correlate with severity of illness, demographics or other risk factors. MATERIALS AND METHODS Included in this study are all individuals that had confirmed COVID-19 and came for a follow up CT of the chest at Landspitali from May to September 2020. Information regarding medical history was obtained retrospectively from medical charts. All CT scans were reviewed using an international staging system to evaluate the extent of lung changes. RESULTS Eighty-five patients with a mean age of 59 years were included in the study. Sixty patients (71%) were hospitalized during the acute phase and 18 (21%) were admitted to the ICU. During the acute phase more pronounced lung involvement was seen in males and patients admitted to the ICU. At follow-up females had less lung involvement but there was a significant relationship between a higher CT score and age, ICU admissions and days in the ICU. Full recovery was seen at follow-up CT in 31% of patients (median 68,5 days between acute and follow-up imaging). CONCLUSION Patients with severe COVID-19 have more pronounced lung involvement on CT than patients with milder disease during the acute phase and follow-up. Older patients and males are at greater risk of acute and persistent COVID-19 related lung changes