Post-COVID interstitial lung disease in symptomatic patients after COVID-19 disease

Abstract

COVID-19 is often associated with long-lasting pulmonary symptoms. Data are scarce about interstitial lung disease (ILD) in patients following COVID-19 hospitalization with persistent symptoms. We retrospectively reviewed all cases sent to pulmonary post-COVID evaluation due to persistent symptoms between February 2021 and February 2022 (N = 318). All patients with suspected ILD (N = 44) were reviewed at the multidisciplinary discussion. Patient characteristics, symptoms, time since hospitalization, detailed lung function measurements and 6-min walk test (6MWT) were evaluated. The post-COVID ILD suspected group included more men (68.2 vs. 31.8%) with significantly older age compared to the control group (64.0 ± 12.3 vs. 51.3 ± 14.9 years). Most patient needed hospital care for COVID-19 pneumonia (68.6% of all patients and 84.1% of ILD suspected group) and average time since hospitalization was 2.4 ± 2.3 months. Persisting symptoms included fatigue (34%), dyspnoea (25.2%), cough (22.6%), and sleep disorders (insomnia 13.2%; sleepiness 8.2%). Post-COVID ILD presented more often with new symptoms of cough and sleepiness. Functional impairment, especially decreased walking distance and desaturation during 6-min walk test (6MWT) were detected in the ILD-suspected group. Respiratory function test in the post-COVID ILD group showed slight restrictive ventilatory pattern (FVC: 76.7 ± 18.1%, FEV1: 83.5 ± 19.1%, TLC: 85.6 ± 28.1%) and desaturation during 6MWT were detected in 41% of patients. LDCT changes were mainly ground glass opacities (GGO) and/or reticular abnormalities in most cases affecting < 10% of the lungs. Our data indicate that suspected post-COVID ILD is affecting 13.8% of symptomatic patients. High resolution chest CT changes were mainly low extent GGO/reticulation, while long-term lung structural changes need further evaluation.

Post-COVID changes in lung function 6 months after veno-venous extracorporeal membrane oxygenation: a prospective observational clinical trial

“…This finding is similar to ours. The dominance of lung volume loss over the fibrotic lung tissue modeling according to the long-term effects of severe COVID-19 is also in agreement with previous results showing consistent decreases in DLCO ( 7 , 10 , 12 , 13 , 31 , 32 , 34 , 36 , 37 ) with preserved KCO ( 10 , 12 , 13 , 32 ).…”

Effects of pharmacotherapy on post-COVID-19 pulmonary fibrosis: Systemic review

“…There were 2 clinical trials proving positive effects of corticosteroids use on the pulmonary function [9,10] and 4 publications reporting their possible negative effects [11][12][13][14]. [15] compared effects of methylprednisolone (80 mg, a continuous daily infusion for 8 days) with dexamethasone (6 mg once daily for up to 10 days) in adult patients with COVID-19 pneumonia requiring oxygen or noninvasive respiratory support.…”

“…Among these works higher frequency of antibiotics and corticosteroids use was seen in patients with negative prognosis. Corticosteroids in most of works were considered as negative predictive factors [11][12][13][14]. Two works described some nonsignificant benefits of MSC regarding post-COVID-19 pulmonary sequelae [18,19].…”

Changing Face of Inflammatory Activation in Complex Coronary Artery Disease during the COVID-19 Pandemic

“…This phenomenon was not significant for one-year mortality, but as mentioned earlier, the time perspective of such inflammatory response in the during-COVID group was limited to several weeks. Fesu et al presented functional impairment, presenting as decreased walking distance and desaturation, within 10 weeks following SARS-CoV-2 infection [36]. Neurological complications persisting 3 months after the acute phase of viral infection were underlined by Ariza et al [37].…”