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Several studies have indicated that patients infected with SARS-CoV-2 develop lingering radiologic and pulmonary diffusion abnormalities; however, the lasting consequences of this relatively new disease have yet to be fully described. Investigators at a single medical center in Madrid designed a prospective, observational study of adults who survived hospitalization for SARS-CoV-2 pneumonia to assess its long-term pulmonary sequelae. Subjects were stratified into those with moderate disease (oxygen saturation [SpO2] ≥90% with supplemental oxygen by mask or nasal prongs) or severe disease (ventilatory support required).
Among the 305 participants, disease was severe in 143 and moderate in 162. By 6 months after symptom onset, cough was still present in 14% (severe disease) versus 26% (moderate disease; P=0.033). However, only 42% of those with severe disease had normal chest radiographs versus 76% with moderate disease (P<0.001), and pulmonary function tests were normal in only 41% (severe) compared with 60% (moderate; P<0.001). The predicted diffusing capacity for carbon monoxide (DLCO) was 71% (severe) versus 83% (moderate; P<0.001). About one third of each group had a serum D-dimer >500 ng/mL. After 10 months, likelihood of normal chest imaging was 71% versus 91%, and respiratory function had normalized in 51% versus 64% of patients with severe compared with moderate disease.
Vargas Centanaro G et al. Long-term outcomes and recovery of patients who survived COVID-19: LUNG INJURY COVID-19 Study. Open Forum Infect Dis 2022 Feb 25; [e-pub]. (https://doi.org/10.1093/ofid/ofac098)
Comment
These results indicate that, despite some improvement after 6 months, respiratory abnormalities may persist nearly 1 year after initial symptoms among patients with SARS-CoV-2 pneumonia and are more likely in those with severe compared with moderate disease. This study only addressed respiratory parameters and so does not illuminate the degree to which other symptoms persist after COVID-19.