Complications after discharge with COVID-19 infection and risk factors associated with development of post-COVID pulmonary fibrosis
| Autor: | Michael Bridgett, Victoria Taylor, Cristiano van Zeller, Sisa Grubnic, Helen Meredith, Nicola Walters, Jessica Gates, A. Draper, Roisin Dunwoody, Sachelle Ruickbie, Tersesa Jacob, Anne Dunleavy, Y. E. Ong, Raminder Aul |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine myalgia medicine.medical_specialty Pulmonary Fibrosis Pulmonary function testing Risk Factors Internal medicine Pulmonary fibrosis Prevalence medicine Humans Risk factor Respiratory system Long term complications of COVID-19 Lung Pandemics Original Research SARS-CoV-2 business.industry COVID-19 Post COVID Fibrosis Middle Aged medicine.disease Patient Discharge United Kingdom Respiratory Function Tests medicine.anatomical_structure Breathing medicine.symptom Cytokine storm business |
| Zdroj: | Respiratory Medicine |
| ISSN: | 0954-6111 |
| DOI: | 10.1016/j.rmed.2021.106602 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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