Late symptoms and lung function tests after severe COVID-19
DOI:
https://doi.org/10.14748/s5evjq78Keywords:
lung function, symptoms, long COVIDAbstract
Introduction: A number of studies have shown that a significant proportion of patients with COVID-19 have symptoms and lung function abnormalities long after the acute phase of the infection.
Aim: The aim of this article is to determine the incidence and character of late symptoms and functional disturbances after severe COVID-19.
Materials and Methods: A total of 26 patients hospitalized at St. Marina University Hospital in Varna for severe COVID-19 in the period October 2021–February 2022 were prospectively studied. The mean age of the patients was 62.15 ± 7.49 years. There were 8 men (30.8%) and 18 women (69.2%). On average, 20 months after hospitalization, the patients were surveyed for available symptoms and functional tests were performed—spirometry and diffusing capacity for carbon monoxide (DLco).
Results: The most common late symptoms were: fatigue—17 patients (65.4%), brain fog—13 patients (50%), weight gain—12 patients (46.2%). Twenty patients (76.9%) had more than one symptom; the mean number of symptoms was 4.8. Abnormal spirometry was found in 4 patients (15.4%), as restrictive pattern is more common. Sixteen patients (61.5%) had decline in diffusion capacity with a mean value of 71.17%. No significant correlations were found between the number of clinical symptoms and the functional tests.
Conclusion: Twenty months after hospitalization for severe COVID-19, many patients still have symptoms and functional disturbances. The long-term effects of COVID-19 are yet to be revealed.
References
[1] COVID-19 cases | WHO COVID-19 dashboard [Internet]. datadot. Available from: https://data.who.int/dashboards/covid19/cases?m49=001
[2] Greenhalgh T, Knight M, A'Court C, et al. Management of post-acute COVID-19 in primary care. BMJ. 2020 Aug 11;370:m3026. doi: 10.1136/bmj.m3026. DOI: https://doi.org/10.1136/bmj.m3026
[3] COVID-19 rapid guideline: managing the long-term effects of COVID-19. London: National Institute for Health and Care Excellence (NICE); 2024 Jan 25.
[4] Davis HE, McCorkell L, Vogel JM, et al. Long COVID: major findings, mechanisms and recommendations. Nat Rev Microbiol. 2023 Mar;21(3):133-46. doi: 10.1038/s41579-022-00846-2. DOI: https://doi.org/10.1038/s41579-022-00846-2
[5] Li J, Zhou Y, Ma J, et al. The long-term health outcomes, pathophysiological mechanisms and multidisciplinary management of long COVID. Signal Transduct Target Ther. 2023 Nov 1;8(1):416. doi: 10.1038/s41392-023-01640-z. DOI: https://doi.org/10.1038/s41392-023-01640-z
[6] McElvaney OJ, McEvoy NL, McElvaney OF, et al. Characterization of the Inflammatory Response to Severe COVID-19 Illness. Am J Respir Crit Care Med. 2020 Sep 15;202(6):812-21. doi: 10.1164/rccm.202005-1583OC. DOI: https://doi.org/10.1164/rccm.202005-1583OC
[7] Littlefield KM, Watson RO, Schneider JM, et al. SARS-CoV-2-specific T cells associate with inflammation and reduced lung function in pulmonary post-acute sequalae of SARS-CoV-2. PLoS Pathog. 2022 May 26;18(5):e1010359. doi: 10.1371/journal.ppat.1010359. DOI: https://doi.org/10.1371/journal.ppat.1010359
[8] Fine MJ, Auble TE, Yealy DM, et al. A Prediction Rule to Identify Low-Risk Patients with Community-Acquired Pneumonia. N Engl J Med. 1997. Jan 23;336(4):243–50. doi: 10.1056/NEJM199701233360402 DOI: https://doi.org/10.1056/NEJM199701233360402
[9] Fan G, Tu C, Zhou F, et al. Comparison of severity scores for COVID-19 patients with pneumonia: a retrospective study. Eur Respir J. 2020. Sep;56(3):2002113. doi: 10.1183/13993003.02113-2020 DOI: https://doi.org/10.1183/13993003.02113-2020
[10] Davis HE, Assaf GS, McCorkell L, et al. Characterizing long COVID in an international cohort: 7 months of symptoms and their impact. EClinicalMedicine. 2021 Aug;38:101019. doi: 10.1016/j.eclinm.2021.101019. DOI: https://doi.org/10.1016/j.eclinm.2021.101019
[11] Huang L, Li X, Gu X, et al. Health outcomes in people 2 years after surviving hospitalisation with COVID-19: a longitudinal cohort study. Lancet Respir Med. 2022 Sep;10(9):863-876. doi: 10.1016/S2213-2600(22)00126-6. DOI: https://doi.org/10.1016/S2213-2600(22)00126-6
[12] Taquet M, Sillett R, Zhu L, et al. Neurological and psychiatric risk trajectories after SARS-CoV-2 infection: an analysis of 2-year retrospective cohort studies including 1 284 437 patients. Lancet Psychiatry. 2022 Oct;9(10):815-827. doi: 10.1016/S2215-0366(22)00260-7. DOI: https://doi.org/10.1016/S2215-0366(22)00260-7
[13] Nitish MS, Revadi G, Sampath A, et al. The Post-COVID-19 Haul on Pulmonary Function: A Prospective Cross-Sectional Study. Cureus. 2024;26;16(5):e61101. doi: 10.7759/cureus.61101. DOI: https://doi.org/10.7759/cureus.61101
[14] Barisione G, Brusasco V. Lung diffusing capacity for nitric oxide and carbon monoxide following mild-to-severe COVID-19. Physiol Rep. 2021;9:1–10. doi: 10.14814/phy2.14748. DOI: https://doi.org/10.14814/phy2.14748
[15] Torres-Castro R, Vasconcello-Castillo L, Alsina-Restoy X, Solis-Navarro L, Burgos F, Puppo H, Vilaró J. Respiratory function in patients post-infection by COVID-19: a systematic review and meta-analysis. Pulmonology. 2021 Jul-Aug;27(4):328-337. doi: 10.1016/j.pulmoe.2020.10.013. DOI: https://doi.org/10.1016/j.pulmoe.2020.10.013
[16] Lee JH, Yim JJ, Park J. Pulmonary function and chest computed tomography abnormalities 6-12 months after recovery from COVID-19: a systematic review and meta-analysis. Respir Res. 2022;23(1):233. doi: 10.1186/s12931-022-02163-x. DOI: https://doi.org/10.1186/s12931-022-02163-x
[17] González J, Zuil M, Benítez ID, et al. One Year Overview and Follow-Up in a Post-COVID Consultation of Critically Ill Patients. Front Med (Lausanne). 2022 Jul 14;9:897990. doi: 10.3389/fmed.2022.897990. DOI: https://doi.org/10.3389/fmed.2022.897990
[18] Faverio P, Luppi F, Rebora P, et al. One-year pulmonary impairment after severe COVID-19: a prospective, multicenter follow-up study. Respir Res. 2022;23(1):65. doi: 10.1186/s12931-022-01994-y. DOI: https://doi.org/10.1186/s12931-022-01994-y
[19] Huang L, Yao Q, Gu X, et al. 1-year outcomes in hospital survivors with COVID-19: a longitudinal cohort study. Lancet. 2021;398(10302):747–58. doi: 10.1016/S0140-6736(21)01755-4. DOI: https://doi.org/10.1016/S0140-6736(21)01755-4
[20] Steinbeis F, Thibeault C, Doellinger F, et al. Severity of respiratory failure and computed chest tomography in acute COVID-19 correlates with pulmonary function and respiratory symptoms after infection with SARS-CoV-2: An observational longitudinal study over 12 months. Respir Med. 2022;191:106709. doi: 10.1016/j.rmed.2021.106709. DOI: https://doi.org/10.1016/j.rmed.2021.106709
[21] Sanhueza S, Vidal MA, Hernandez MA, et al. Clinical and pulmonary function analysis in long-COVID revealed that long-term pulmonary dysfunction is associated with vascular inflammation pathways and metabolic syndrome. Front Med (Lausanne). 2023; 6;10:1271863. doi: 10.3389/fmed.2023.1271863. DOI: https://doi.org/10.3389/fmed.2023.1271863
[22] Cornelissen MEB, Leliveld A, Baalbaki N, et al. Pulmonary function 3-6 months after acute COVID-19: A systematic review and multicentre cohort study. Heliyon. 2024 Mar 13;10(6):e27964. doi: 10.1016/j.heliyon.2024.e27964. DOI: https://doi.org/10.1016/j.heliyon.2024.e27964
[23] Patton MJ, Benson D, Robison SW, et al. Characteristics and determinants of pulmonary long COVID. JCI Insight. 2024 Apr 23;9(10):e177518. doi: 10.1172/jci.insight.177518. DOI: https://doi.org/10.1172/jci.insight.177518
[24] Han X, Chen L, Guo L, et al. Long-term radiological and pulmonary function abnormalities at 3 years after COVID-19 hospitalisation: a longitudinal cohort study. Eur Respir J. 2024 Jul 18;64(1):2301612. doi: 10.1183/13993003.01612-2023. DOI: https://doi.org/10.1183/13993003.01612-2023
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