Residual symptoms, lung function, and imaging findings in patients recovering from SARS-CoV-2 infection

Abstract

Symptoms following acute COVID-19 infection are common, but their relationship to initial COVID-19 severity is unclear. We hypothesize that residual symptoms are related to disease severity, and severe acute COVID-19 infection is more likely to cause residual pulmonary damage. This study aims to evaluate symptoms, lung function, and abnormal imaging within 3 months following COVID-19 infection, and to determine whether they are related to initial disease severity. A cross-sectional study was carried out at a designated post-COVID clinic in Hadassah Medical Center, Jerusalem, Israel. Patients with PCR-confirmed SARS-CoV-2 infection were evaluated within 12 weeks following infection and included both admitted and non-admitted subjects. All study participants underwent assessment of symptoms, quality of life (SGRQ), pulmonary function tests, and imaging. A total of 208 patients (age 49.3 ± 16 years) were included in the study. Initial disease severity was mild in 86, moderate in 49, and severe in 73 patients. At the time of follow-up, there were no differences in frequency of residual symptoms or in SGRQ score between groups. Patients with severe COVID-19 were more likely to have residual dyspnea ( p = 0.04), lower oxygen saturation ( p < 0.01), lower FVC and TLC ( p < 0.001, p = 0.03 respectively), abnormal CXR ( p < 0.01), and abnormal CT scan ( p < 0.01) compared to other groups.Frequency of symptoms and impairment of quality of life at 12 week follow-up are common and are not related to severity of initial COVID-19 disease. In contrast, reduced lung function and abnormal pulmonary imaging are more common in patients with more severe acute COVID-19 infection.

Pulmonary function 3–6 months after acute COVID-19: A systematic review and multicentre cohort study

“…Results of all included studies can be found in Table S1 . All studies included a population with a mean or median age between 47 and 66 years and most studies had an equal distribution of males and females.The majority of the studies were conducted in Europe (n = 26) [ [3] , [4] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] ],49,51,56,60,62,65,66,67,69,70,74,76,77,79,80,81,83,84], six were conducted in North America [ [59] , [60] , [61] , [62] , [63] , [64] ], four in South America [ [65] , [66] , [67] , [68] ] and eleven in Asia [ [16] , [17] , [69] , [70] , [71] , [72] , [73] , [74] , [75] , [76] , [77] ]. The population of the studies varied between 17 and 1733 with a mean of 177 participants.…”

Post-COVID-19 syndrome: nature of symptoms and associated factors

“…More than four studies concluded that initial symptoms of COVID-19 infection are not significantly associated with post-COVID-19 syndrome (Townsend et al 2021 ; Darawshy et al 2022 ; Stengel et al 2021 ; Townsend et al 2020 ; Miyazato et al 2020 ). However, the current study revealed that several symptoms, mainly insomnia, drowsiness, and shortness of breath, are risk factors for long COVID-19 symptoms, with odds ratios >3.…”

Elevated circulating monocytes and monocyte activation in COVID-19 convalescent individuals

“…This approach clarified the presence of pulmonary symptoms and may not discern individuals who had their symptoms overestimated based on the questionnaire. Studies demonstrate that pulmonary symptoms were present regardless of initial COVID severity, but patients with severe COVID-19 were more likely to have impairment of lung function ( 32 , 33 ). Also, pulmonary symptoms were presented without impairment of lung function or cardiopulmonary exercise test among COVID-19 survivors ( 33 ).…”