Complications after discharge with COVID-19 infection and risk factors associated with development of post-COVID pulmonary fibrosis - 23/10/21
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Abstract |
Introduction |
Survivors of COVID-19 infection may develop post-covid pulmonary fibrosis (PCF) and suffer from long term multi-system complications. The magnitude and risk factors associated with these are unknown.
Objectives |
We investigated the prevalence and risk factors associated with PCF and other complications in patients discharged after COVID-19 infection.
Methods |
Patients had phone assessment 6 weeks post hospital discharge after COVID-19 infection using a set protocol. Those with significant respiratory symptoms were investigated with a CTPA, Pulmonary Function Tests and echocardiogram. Prevalence of myalgia, fatigue, psychological symptoms and PCF was obtained. Risk factors associated with these were investigated.
Results |
A large number of patients had persistent fatigue (45.1%), breathlessness (36.5%), myalgia (20.5%) and psychological symptoms (19.5%). PCF was seen in 9.5% of the patients and was associated with persistent breathlessness at 6 weeks and inpatient ventilation [adjusted OR 5.02(1.76–14.27) and 4.45(1.27–15.58)] respectively. It was more common in men and in patients with peak CRP >171.5 mg/L, peak WBC count ≥12 × 10 9/L, severe inpatient COVID-19 CXR changes and CT changes. Ventilation was also a risk factor for persisting fatigue and myalgia, the latter was also more common in those with severe cytokine storm and severe COVID-19 inpatient CXR changes.
Conclusions |
All the patients discharged after COVID-19 should be assessed using a set protocol by a multidisciplinary team. Patients who had severe COVID-19 infection particularly those who were intubated and who have persistent breathlessness are at risk of developing PCF. They should have a CT Chest and have respiratory follow-up.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Persistent fatigue, breathlessness and myalgia are common after COVID-19 infection. |
• | 9.3% of the patients with persistent respiratory symptoms have Post Covid Pulmonary Fibrosis (PCF). |
• | Breathlessness at 6 weeks and prior intubation are the strongest risk factors associated with PCF. |
Keywords : COVID-19, Post COVID Fibrosis, Long term complications of COVID-19
Plan
Vol 188
Article 106602- novembre 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.