Predictors of symptom persistence and respiratory sequelae in respiratory symptomatics presenting to a post-COVID clinic
Background: COVID-19 infection causes the persistence of respiratory symptoms and functional impairment, which require prolonged follow-up care. Identification of individuals at risk for respiratory sequelae helps in optimal follow-up and early identification of complications. Aims and Objectives...
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| Format: | Article |
| Language: | English |
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Manipal College of Medical Sciences, Pokhara
2023-10-01
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| Series: | Asian Journal of Medical Sciences |
| Subjects: | |
| Online Access: | https://www.nepjol.info/index.php/AJMS/article/view/55785 |
| _version_ | 1797668590189543424 |
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| author | Athulya S Kumar Venugopal KP Sajitha M John Sonia |
| author_facet | Athulya S Kumar Venugopal KP Sajitha M John Sonia |
| author_sort | Athulya S Kumar |
| collection | DOAJ |
| description | Background: COVID-19 infection causes the persistence of respiratory symptoms and functional impairment, which require prolonged follow-up care. Identification of individuals at risk for respiratory sequelae helps in optimal follow-up and early identification of complications.
Aims and Objectives: The present study aims to find the clinical profile, predictors of respiratory symptom persistence, and functional impairment in post-COVID patients.
Materials and Methods: Prospective observational study was done on patients who attended the post-COVID clinic in the pulmonary medicine outpatient department (OPD) in a tertiary care center in central Kerala from June 2021 to August 2021 with persisting respiratory symptoms after becoming COVID-19 negative and evaluated with a proforma regarding clinical history and symptoms. Patients were followed up at one and 3 months. Clinical, functional, and radiological factors were assessed. They were reassessed at 3 months. Spirometry was done in those with persistent symptoms at 3 months. High-resolution computed tomography (CT) was performed in those with significant desaturation on 6-min walk test (6MWT).
Results: Of 348 patients, 6 died, 4 lost follow-up, 12 patients had alternative diagnoses during the study period. About 29.4% were symptomatic at 3 months. CT severity score improved over 3 months and the proportion of patients with exercise-induced desaturation in 6MWT decreased over 3 months. All patients showed a restrictive abnormality except two. A significant association was found between the persistence of symptoms at 3 months and type 2 diabetes mellitus, severe illness during the initial phase, persistent elevation of inflammatory markers, and increased radiological involvement. Alternative diagnosis and treatment-related complication was seen in 12 patients, which included infections such as tuberculosis, nocardia and fungal infection, malignancy, CTEPH, and post-intubation tracheal stenosis.
Conclusion: A minor group of severe COVID-19 pneumonia survivors have delayed resolution of symptoms with functional impairment. Improvement in spirometry lags behind clinical and radiological improvement. |
| first_indexed | 2024-03-11T20:31:34Z |
| format | Article |
| id | doaj.art-a9b617c3127f4492bc180094f627a4e5 |
| institution | Directory Open Access Journal |
| issn | 2467-9100 2091-0576 |
| language | English |
| last_indexed | 2024-03-11T20:31:34Z |
| publishDate | 2023-10-01 |
| publisher | Manipal College of Medical Sciences, Pokhara |
| record_format | Article |
| series | Asian Journal of Medical Sciences |
| spelling | doaj.art-a9b617c3127f4492bc180094f627a4e52023-10-02T08:33:45ZengManipal College of Medical Sciences, PokharaAsian Journal of Medical Sciences2467-91002091-05762023-10-01141038https://doi.org/10.3126/ajms.v14i10.55785Predictors of symptom persistence and respiratory sequelae in respiratory symptomatics presenting to a post-COVID clinicAthulya S Kumar 0https://orcid.org/0009-0006-3784-3169Venugopal KP 1https://orcid.org/0000-0002-1706-9798Sajitha M 2https://orcid.org/0000-0002-0751-8537John Sonia 3https://orcid.org/0009-0007-7632-6508Junior Resident, Department of Pulmonary Medicine, Government Medical College, Kottayam, Kerala, India Associate Professor, Department of Pulmonary Medicine, Government Medical College, Kottayam, Kerala, India Assistant Professor, Department of Pulmonary Medicine, Government Medical College, Kottayam, Kerala, India Assistant Professor, Department of Pulmonary Medicine, Government Medical College, Kottayam, Kerala, India Background: COVID-19 infection causes the persistence of respiratory symptoms and functional impairment, which require prolonged follow-up care. Identification of individuals at risk for respiratory sequelae helps in optimal follow-up and early identification of complications. Aims and Objectives: The present study aims to find the clinical profile, predictors of respiratory symptom persistence, and functional impairment in post-COVID patients. Materials and Methods: Prospective observational study was done on patients who attended the post-COVID clinic in the pulmonary medicine outpatient department (OPD) in a tertiary care center in central Kerala from June 2021 to August 2021 with persisting respiratory symptoms after becoming COVID-19 negative and evaluated with a proforma regarding clinical history and symptoms. Patients were followed up at one and 3 months. Clinical, functional, and radiological factors were assessed. They were reassessed at 3 months. Spirometry was done in those with persistent symptoms at 3 months. High-resolution computed tomography (CT) was performed in those with significant desaturation on 6-min walk test (6MWT). Results: Of 348 patients, 6 died, 4 lost follow-up, 12 patients had alternative diagnoses during the study period. About 29.4% were symptomatic at 3 months. CT severity score improved over 3 months and the proportion of patients with exercise-induced desaturation in 6MWT decreased over 3 months. All patients showed a restrictive abnormality except two. A significant association was found between the persistence of symptoms at 3 months and type 2 diabetes mellitus, severe illness during the initial phase, persistent elevation of inflammatory markers, and increased radiological involvement. Alternative diagnosis and treatment-related complication was seen in 12 patients, which included infections such as tuberculosis, nocardia and fungal infection, malignancy, CTEPH, and post-intubation tracheal stenosis. Conclusion: A minor group of severe COVID-19 pneumonia survivors have delayed resolution of symptoms with functional impairment. Improvement in spirometry lags behind clinical and radiological improvement.https://www.nepjol.info/index.php/AJMS/article/view/55785covid 19; post-covid; respiratory sequelae |
| spellingShingle | Athulya S Kumar Venugopal KP Sajitha M John Sonia Predictors of symptom persistence and respiratory sequelae in respiratory symptomatics presenting to a post-COVID clinic Asian Journal of Medical Sciences covid 19; post-covid; respiratory sequelae |
| title | Predictors of symptom persistence and respiratory sequelae in respiratory symptomatics presenting to a post-COVID clinic |
| title_full | Predictors of symptom persistence and respiratory sequelae in respiratory symptomatics presenting to a post-COVID clinic |
| title_fullStr | Predictors of symptom persistence and respiratory sequelae in respiratory symptomatics presenting to a post-COVID clinic |
| title_full_unstemmed | Predictors of symptom persistence and respiratory sequelae in respiratory symptomatics presenting to a post-COVID clinic |
| title_short | Predictors of symptom persistence and respiratory sequelae in respiratory symptomatics presenting to a post-COVID clinic |
| title_sort | predictors of symptom persistence and respiratory sequelae in respiratory symptomatics presenting to a post covid clinic |
| topic | covid 19; post-covid; respiratory sequelae |
| url | https://www.nepjol.info/index.php/AJMS/article/view/55785 |
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