Pulmonary Complications after COVID-19

Abstract

Coronavirus disease 2019 (COVID-19) is a threat to patients not only because of its acute course, but also because of various complications occurring in the following period, that is, more than 28 days after the onset of acute infection. The present study identified a total of 121 patients hospitalized 29 or more days after the first positive result of a PCR test for SARS-CoV-2, of whom 98 patients were included in the study. Patients were divided into two groups by the time interval between the positive COVID-19 test result and hospitalization date. The time intervals were week 5–11 in an ongoing-COVID group (57.1% of patients) and 12 or more weeks in a post-COVID-group (42.9%). The most frequent reason for hospitalization was respiratory tract infection (58.2%). Pneumonia accounted for 77.2% of these cases. Other reasons for hospitalization were interstitial lung disease (22.4%), pulmonary embolism (8.2%), and sarcoidosis (6.1%). The study group was further divided according to the causes of hospitalization into subgroups with infections and other causes. In the group with infectious diseases, there was a shorter time period between PCR positivity and hospitalization and there were significantly more frequent non-respiratory complications. In the entire sample, the in-hospital mortality was 5.1%.

Distribution of Pathogens and Predictive Values of Biomarkers of Inflammatory Response at ICU Admission on Outcomes of Critically Ill COVID-19 Patients with Bacterial Superinfections—Observations from National COVID-19 Hospital in Croatia

“…Superinfections in critically ill COVID-19 patients are common due to various factors, such as the fact that SARS-CoV-2 may enhance colonization and attachment of bacteria to host tissue, not only during the illness itself, but also in the post-COVID phase [ 11 ]. Airway dysfunction, cytopathology and tissue destruction induced by SARS-CoV-2 infection or during bacterial co-infection may facilitate systemic dissemination of the virus and/or bacterial co-pathogens, dramatically increasing the risk of blood infections and sepsis [ 12 , 13 ].…”

Leading Pathogens Involved in Co-Infection and Super-Infection with COVID-19: Forensic Medicine Considerations after a Systematic Review and Meta-Analysis

“…This can be important in helping to understand the effectiveness of disease prevention and control strategies, as well as in ensuring the correct attribution of causes of death [ 44 ]. COVID-19 patients may develop chronic pulmonary complications [ 45 ] or other diseases as a result of the infection [ 46 , 47 , 48 , 49 ]. Forensic pathology can contribute to the understanding of these complications and the development of appropriate therapies, and provide guidelines on how to manage deaths safely and effectively to protect both staff and the public [ 50 ].…”

Changing Trends in the Incidence and Clinical Features of Pneumocystis jirovecii Pneumonia in Non-HIV Patients before and during the COVID-19 Era and Risk Factors for Mortality between 2016 and 2022

“…If the immune response is excessive, long-term immune dysregulation may occur, increasing vulnerability to secondary infection and organ dysfunction, even after recovery from COVID-19 [ 10 , 14 , 15 ]. Immunocompromised patients are more susceptible to fungal diseases [ 13 ] and PCP is a lethal disease [ 28 ]. Recently, several studies have reported PCP superinfection in patients with severe COVID-19; however, there is no clear definition for distinguishing between infection and colonization [ 22 ].…”

“…Following COVID-19 infections, 5–30% of patients experience long COVID, characterized by various complications [ 10 , 11 ]. The duration of long COVID is reported to be 9 months for hospitalized patients and 4 months for non-hospitalized patients, and the rate of hospitalization for respiratory symptoms following acute COVID-19 infections has increased [ 12 , 13 ].…”