News in brief: Substantial dyspnoea burden in Australian adults; TSANZ medal for pulmonary rehab expert; Pulmonary changes persist long after COVID-19 hospitalisation

Public health

11 May 2021

Dyspnoea reported by 10% of adults

About one in 10 Australians report clinically important levels of breathlessness, according to new findings that suggest underdiagnosis of conditions such as COPD and heart failure.

The National Breathlessness Survey conducted in 2019 involving more than 10,000 participants with a median age of 40-49 found that 9.5% reported mMRC dyspnoea grade ≥ 2 (2 = ‘I walk slower than people of the same age on the level because of breathlessness or have to stop for breath when walking at my own pace on the level’)

Just over half of the breathless group did not report a current respiratory or heart condition diagnosis, indicating that breathlessness was common among Australian adults and is associated with a substantial burden of ill health, according to Woolcock Institute NSW researchers reporting their results in Respirology. Of the breathless group, half rated their general health as fair or poor and 44% had depression or anxiety symptoms.

The study was funded by AstraZeneca Australia, GlaxoSmithKline Australia, Novartis.

TSANZ medal for Prof Anne Holland

The Thoracic Society of Australia and New Zealand has awarded Professor Anne Holland the 2021 TSANZ Society Medal for her outstanding contribution to thoracic medicine. The physiotherapy professor at Monash University and Alfred Health investigates support therapies for patients with chronic respiratory disease and is a chief investigator of the NHMRC-funded Centre of Research Excellence in pulmonary fibrosis.

Professor Hollands’ recent clinical trials have tested new models of pulmonary rehabilitation including low-cost home-based models and telerehabilitation to expand patient access.

Pulmonary changes persist long after COVID-19 hospitalisation

With more than a year of the pandemic behind us, data on the long-term sequelae of COVID-19 continue to accumulate. A new prospective study from China found that a subset of patients who had been hospitalised but did not require mechanical ventilation found persistent physiological and radiographic changes.

Among 83 patients with a median age of 60 years, temporal improvement in pulmonary physiology and exercise capacity was seen at evaluations at three, six, nine, and twelve months following hospital discharge.

However, patients had significant reduction in diffusing capacity of the lungs for carbon monoxide (DLCO) across the study period, with a median of 77% of that predicted at three months, 76% at six months, and 88% a full year after discharge. At that twelve month point, radiological changes persisted in 24% of the cohort.

“Our findings highlight the importance of respiratory follow-up of patients with COVID-19, and that studies to mitigate the long-term consequences of COVID-19 pneumonia, including pulmonary rehabilitation as well as novel therapeutic approaches, are required,” the authors wrote in The Lancet Respiratory Medicine.

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