Lung Function and Symptoms in Post-COVID-19 Patients: A Single-Center Experience.
Mayo Clin Proc Innov Qual Outcomes
; 5(5): 907-915, 2021 Oct.
Article
in En
| MEDLINE
| ID: mdl-34396048
ABSTRACT
OBJECTIVE:
To address the lack of information about clinical sequelae of coronavirus disease 2019 (COVID-19). PATIENTS ANDMETHODS:
Previously hospitalized COVID-19 patients who were attending the outpatient clinic for post-COVID-19 patients (ASST Ovest Milanese, Magenta, Italy) were included in this retrospective study. They underwent blood draw for complete blood count, C-reactive protein, ferritin, D-dimer, and arterial blood gas analysis and chest high-resolution computed tomography (HRCT) scan. The primary endpoint was the assessment of blood gas exchanges after 3 months. Other endpoints included the assessment of symptoms and chest HRCT scan abnormalities and changes in inflammatory biomarkers after 3 months from hospital admission.RESULTS:
Eighty-eight patients (n = 65 men; 73.9%) were included. Admission arterial blood gas analysis showed hypoxia and hypocapnia and an arterial partial pressure of oxygen/fractional inspired oxygen ratio of 271.4 (interquartile range [IQR] 238-304.7) mm Hg that greatly improved after 3 months (426.19 [IQR 395.2-461.9] mm Hg, P<.001). Forty percent of patients were still hypocapnic after 3 months. Inflammatory biomarkers dramatically improved after 3 months from hospitalization. Fever, resting dyspnea, and cough were common at hospital admission and improved after 3 months, when dyspnea on exertion and arthralgias arose. On chest HRCT scan, more than half of individuals still presented with interstitial involvement after 3 months. Positive correlations between the interstitial pattern at 3 months and dyspnea on admission were found. C-reactive protein at admission was positively associated with the presence of interstitial involvement at follow-up. The persistence of cough was associated with presence of bronchiectasis and consolidation on follow-up chest HRCT scan.CONCLUSION:
Whereas inflammatory biomarker levels normalized after 3 months, signs of lung damage persisted for a longer period. These findings support the need for implementing post-COVID-19 outpatient clinics to closely follow-up COVID-19 patients after hospitalization.
ABG, arterial blood gas; COVID-19, coronavirus disease 2019; CRP, C-reactive protein; CT, computed tomography; DOE, dyspnea on exertion; GGO, ground-glass opacity; HRCT, high-resolution computed tomography; IQR, interquartile range; PFT, pulmonary function test; PaCO2, arterial partial pressure of carbon dioxide; PaO2, arterial partial pressure of oxygen; PaO2/FiO2, ratio of arterial partial pressure of oxygen to fractional inspired oxygen; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; V/Q, ventilation/perfusion ratio
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Type of study:
Diagnostic_studies
/
Observational_studies
/
Risk_factors_studies
Language:
En
Journal:
Mayo Clin Proc Innov Qual Outcomes
Year:
2021
Document type:
Article
Affiliation country:
Italia
Publication country:
HOLANDA
/
HOLLAND
/
NETHERLANDS
/
NL
/
PAISES BAJOS
/
THE NETHERLANDS