Research

Long term lung abnormalities seen in people with COVID-19


Respiratory symptoms persist for months after diagnosis in many patients hospitalised with COVID-19, according to new research.

“Understanding long-term respiratory outcomes, and in particular the clinical predictors of poor respiratory outcomes, will direct evidence-based management of post-COVID respiratory care, resource allocation and health system planning,” wrote study authors led by Dr Aditi Shah, of the University of British Columbia in Canada.

The researchers prospectively followed sixty patients hospitalised from March to May 2020 with confirmed COVID-19. Results were published in Thorax.

After a mean follow-up duration of 11.7 weeks, 58% of the patients had at least one abnormal variable on pulmonary function testing (PFT).

Dyspnoea was present in a minority of patients (20%), as was cough (20%). An abnormal diffusion capacity of the lung for carbon monoxide (DLCO) was present in 52% of the cohort, and 45% had an abnormal total lung capacity. Airflow obstruction was observed in 11% of the patients.

On CT scans, 55% of patients had more than 10% of lung volume affected by either ground glass opacity or reticulation.

Oxygen supplementation while hospitalised was significantly associated with DLCO and with CT score. The associations remained significant on a multivariate analysis.

The researchers wrote that: “it is likely that a substantial percentage of these patients will continue to have chronic abnormalities.”

In another study published in Thorax, a UK cohort of hospitalised COVID-19 patients also demonstrated persistent symptoms between eight and 12 weeks after admission.

In that study, which included 110 patients who attended a follow-up clinic of 131 total participants, 74% had persistent symptoms.

The most common such symptoms included breathlessness (39%), fatigue (39%), and insomnia (24%). Myalgia, chest pain, anaemia, and cough were also reported.

In a group considered to have had “mild” COVID-19, 59% reported ongoing symptoms, compared with 75% of those in a “moderate” group and 89% of those in the “severe” group.

“Over 130,000 people have been admitted to hospital with COVID-19 in the UK alone,” the authors wrote.

“These results provide information useful to clinicians caring for survivors of COVID-19 disease. The role(s) of rehabilitation and/or psychological services in the management of such patients warrant research.”

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