The war against coronavirus has been fierce, but researchers have failed to construct a complete picture of the virus. However, it is becoming clear that some symptoms may continue after recovery.

Researchers expect that the coronavirus will be eradicated by 2022, but seasonal outbreaks may still occur in unprotected areas. In scientific circles, figuring out the virus’s long-term consequences is swiftly becoming a top focus.

A new study analyzes data from individuals who were reviewed one year after discharge.

The study comprised over 300 COVID-patients, with over 90% of them being followed for at least a year. Supplemental oxygen alone, continuous positive airway pressure (CPAP) ventilation, and invasive mechanical ventilation (IMV) were used in about 60, 140, and 90 patients, respectively. During the second half of the research, no patients died, however, five required re-admission for various reasons.

Almost 70% of patients had never smoked, and around 80% had no or only one underlying medical problem. In both groups, the incidence of pulmonary thromboembolism and deep vein thrombosis was modest and comparable.

The oxygen alone group had the lowest carbon monoxide diffusion capacity (DLCO) and the CPAP group had the least change. Between 6 and 12 months, DLCO improved by 2.5 percent in the CPAP and IMV groups. Only a few individuals exhibited restrictive lung alterations or were obstructive, albeit four of the latter had smoked in the past or were still smoking, and one was asthmatic.

Other functions were comparable between groups, except that one in five patients walked less than expected. There were no cases of low oxygen desaturation or the need for supplementary oxygen in any of the groups.

With light activity, almost 40 percent of patients felt some breathlessness, while 34 patients said they had to walk slowly or stop to regain their breath. When the 6- and 12-month follow-ups were examined, there was a small but substantial increase in reports of breathlessness in all groups. None of the patients took part in any type of rehabilitation.

Radiological abnormalities were found in 80 percent of IMV patients, 65 percent of CPAP patients, and 46 percent of oxygen-only patients. When compared to the last, the risk was more than eight times higher in the first group and over three times higher in the second.

The majority of the high-resolution CT (HRCT) scans revealed interstitial lung alterations; more than half of the scans revealed ground-glass opacities, more than third revealed reticular abnormalities, and less than 5 percent each revealed consolidations and honeycombing. Ground glass opacities were associated with traction bronchiectasis or bronchiectasis in 44 percent of cases.

Nearly 60% of individuals with a normal DLCO showed HRCT abnormalities, but this proportion increased to 77 percent when the DLCO was compromised. The same was true for ground-glass opacities, which were 45 percent and 61 percent, respectively. Reticular abnormalities were seen in 28 percent and almost 50 percent of patients, respectively.

The data reveal that lung fibrosis is a rare complication after SARS-CoV-2 infection that necessitates hospitalization, with just 1 percent of patients demonstrating this problem 12 months after discharge. Other modest interstitial findings, notably ground-glass opacities and reticular abnormalities, were seen in the majority of cases, although only in a single lobe and to a limited extent.

This corroborates previous accounts but does not assist in determining whether the harm was caused by the virus or by changes in lung pressure or volume caused by the IMV, even though the cystic abnormalities and pneumatocele formation noted in the latter case were not observed here.

Age is a strong predictor of long-term radiological consequences. The prevalence of DLCO impairment was higher in oxygen-only and IMV patients, however this could be related to selection bias.

“Despite the mild entity of the functional sequelae, a consistent proportion of patients at 1-year from SARS-CoV-2 pneumonia still report exertional dyspnea (35%) with a worsening trend compared to the 6-month visit,” the researchers write.

The fact that this was irrespective of the degree of lung symptoms during hospitalization suggests that lung damage is caused by a similar mechanism rather than being only dependent on pneumonia severity. Because of the devastating effects of long Covid, such people require psychological help and rehabilitation.

Indeed, when these findings are combined with those of other studies, it appears that elderly patients with SARS-CoV-2 pneumonia who require IMV should be closely monitored in order to detect long-term pulmonary sequelae, while the other groups should not be overlooked. Both DLCO and HRCT can detect pulmonary sequelae, which normally improve within 6 to 12 months.

Source: 10.1186/s12931-022-01994-y

Image Credit: Getty

You were reading: A potentially fatal complication hints you’re still under the attack of COVID – even after a year of recovery