Long Term Respiratory Follow up Findings of COVID-19 Cases

Year 2025, Volume: 7 Issue: 1, 10 - 19, 25.02.2025

Kadir Çoban , Olcay Ayçiçek , Tevfik Özlü

https://doi.org/10.52827/hititmedj.1510125

Abstract

Objective: The aim of this study was to determine the long-term clinical, laboratory and radiologic findings, long-term follow-up findings after acute infection and complications in patients who recovered from COVID-19 infection, especially in patients with insufficient data on long-term effects.
Material and Method: Patients who were admitted to the pulmonology outpatient clinic of our hospital and recovered from COVID-19 infection were included in the study. Demographic data, peripheral oxygen saturation, mMRC score, 6-minute walk test data, ongoing symptoms, laboratory data, radiologic findings and complications during follow-up were recorded. Patients admitted up to the first 4 weeks from the time of diagnosis were grouped as visit 1, patients admitted between 4 and 12 weeks were grouped as visit 2, and patients admitted after 12 weeks were grouped as visit 3.
Results: A total of 520 patients were evaluated, including 190 patients at the first visit interval, 203 patients at the second visit interval and 127 patients at the third visit interval, including duplicate patients. 54% of the participants were female, 46% were male and the mean age was 54 years. Patients had at least one ongoing symptom in 96.3%, 90.6% and 89.8% of the visits, respectively. The most common symptoms were exertional dyspnea, fatigue and cough. The most common pathologic radiographic findings were ground glass opacities in the early period and linear/reticular opacities in the late period. The rates of complications during follow-up were 4.7%, 23.2%, 24.4% according to the visit intervals, respectively and the most common complication was pulmonary fibrosis.
Conclusion: COVID-19 patients; while struggling with the problems associated with the acute disease in the early period, they also have to struggle with persistent symptoms and newly developing complications in the long term. In this context, we think that our study will form a basis for the data of our country and contribute to the literature.

Keywords

COVID-19, Post-COVID, Long-COVID

Ethical Statement

The study was conducted in accordance with the Declaration of Helsinki and was reviewed and approved by the local Ethics Committee (Protocol No: 2021/9, Date: 28.01.2021).

Supporting Institution

No financial disclosure was declared by the authors.

Project Number

2021/9

COVID-19 Olgularının Uzun Dönem Solunumsal Takip Bulguları

Abstract

Amaç: Bu çalışmayla özellikle uzun dönem etkileri hakkında yeterli veri olmayan COVID-19 enfeksiyonunu geçirip iyileşen hastaların; uzun dönem klinik, laboratuvar ve radyolojik bulgularının, akut enfeksiyon sonrası uzun vadeli takip bulgularının ve komplikasyonların ortaya konması amaçlanmıştır.
Gereç ve Yöntem: Çalışmaya hastanemiz göğüs hastalıkları polikliniğine başvuran, COVID-19 enfeksiyonu geçirip iyileşen hastalar dahil edildi. Hastaların demografik verileri, periferik oksijen satürasyonu, mMRC skoru, 6 dakika yürüme testi verileri, devam eden semptomları, laboratuvar verileri, radyolojik bulguları ve takipte gelişen komplikasyonlar kaydedildi. Tanı anından itibaren ilk 4 haftaya kadar olan sürede başvuran hastalar 1. vizit, 4 ila 12. hafta arasında başvuran hastalar 2. vizit, 12. haftadan sonra başvuran hastalar 3. vizit aralığı olarak gruplandırıldı.
Bulgular: İlk vizit aralığında 190, 2. vizit aralığında 203 ve 3. vizit aralığında 127 olmak üzere mükerrer hastalarla birlikte toplam 520 hasta değerlendirildi. Katılımcıların %54’ü kadın, %46’sı erkek ve ortalama yaş 54’tü. Hastaların, vizit aralıklarına göre sırasıyla %96,3, %90,6, %89,8 oranında devam eden en az bir semptomu mevcuttu. En sık izlenen semptomlar; efor dispnesi, halsizlik, öksürük şeklinde sıralandı. En sık patolojik grafi bulgusu erken dönemlerde buzlu cam opasiteleri iken geç dönemde çizgisel/retikuler opasiteler olarak görüldü. Takipte komplikasyon izlenme oranları vizit aralıklarına göre sırasıyla %4,7, %23,2, %24,4 olarak izlendi ve en sık izlenen komplikasyonun akciğer fibrozisi olduğu görüldü.
Sonuç: COVID-19 hastaları; erken dönemde akut hastalıkla ilişkili sorunlarla mücadele ederken, uzun dönemde de sebat eden semptomlar ve yeni gelişen komplikasyonlarla mücadele etmek zorunda kalmaktadır. Bu bağlamda, çalışmamızın ülkemiz verilerine dayanak oluşturacağını ve literatüre katkı sağlayacağını düşünmekteyiz.

Keywords

COVID-19, Post-COVID, Long-COVID

Ethical Statement

Çalışma Karadeniz Teknik Üniversitesi Tıp Fakültesi Bilimsel Araştırmalar Etik Kurulu etik komite tarafından onaylamıştır (Protokol No: 2021/9, Tarih: 28.01.2021).

Project Number

2021/9

References

• Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China [published correction appears in Lancet 2020 Feb 15;395(10223).
• https://apps.who.int/iris/handle/10665/330992. (accessed on 2021 Oct 6).
• https://data.who.int/dashboards/covid19. (accessed on 2024 Apr 7).
• Huang L, Yao Q, Gu X, et al. 1-year outcomes in hospital survivors with COVID-19: a longitudinal cohort study [published correction appears in Lancet 2022 May 7;399(10337).
• Gorna R, MacDermott N, Rayner C, et al. Long COVID guidelines need to reflect lived experience. Lancet 2021;397(10273):455-457.
• Huang C, Huang L, Wang Y, et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet 2023;401(10393):e21-e33.
• Carfì A, Bernabei R, Landi F; Gemelli Against COVID-19 Post-Acute Care Study Group. Persistent Symptoms in Patients After Acute COVID-19. JAMA 2020;324(6):603-605.
• Natarajan A, Shetty A, Delanerolle G, et al. A systematic review and meta-analysis of long COVID symptoms. Syst Rev 2023;12(1):88.
• Stefanou MI, Palaiodimou L, Bakola E, et al. Neurological manifestations of long-COVID syndrome: a narrative review. Ther Adv Chronic Dis 2022;13.
• Wijeratne T, Crewther S. Post-COVID 19 Neurological Syndrome (PCNS); a novel syndrome with challenges for the global neurology community. J Neurol Sci 2020;419.
• Kermali M, Khalsa RK, Pillai K, Ismail Z, Harky A. The role of biomarkers in diagnosis of COVID-19 - A systematic review. Life Sci 2020;254.
• Gameil MA, Marzouk RE, Elsebaie AH, Rozaik SE. Long-term clinical and biochemical residue after COVID-19 recovery. Egypt Liver J 2021;11(1):74.
• Rostami M, Mansouritorghabeh H. D-dimer level in COVID-19 infection: a systematic review. Expert Rev Hematol 2020;13(11):1265-1275.
• Cheng L, Li H, Li L, et al. Ferritin in the coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis. J Clin Lab Anal 2020;34(10).
• Yong SJ, Halim A, Halim M, et al. Inflammatory and vascular biomarkers in post-COVID-19 syndrome: A systematic review and meta-analysis of over 20 biomarkers. Rev Med Virol 2023;33(2).
• Mandal S, Barnett J, Brill SE, et al. ‘Long-COVID’: a cross-sectional study of persisting symptoms, biomarker and imaging abnormalities following hospitalisation for COVID-19. Thorax 2021;76(4):396-398.
• Gao Y, Liang WQ, Li YR, He JX, Guan WJ. The Short- and Long-Term Clinical, Radiological and Functional Consequences of COVID-19. Arch Bronconeumol 2022;58:32-38.
• Bazdar S, Kwee AKAL, Houweling L, et al. A Systematic Review of Chest Imaging Findings in Long COVID Patients. J Pers Med 2023;13(2):282.
• McDonald LT. Healing after COVID-19: are survivors at risk for pulmonary fibrosis?. Am J Physiol Lung Cell Mol Physiol 2021;320(2):L257-L265.
• Elhiny R, Al-Jumaili AA, Yawuz MJ. An overview of post-COVID-19 complications. Int J Clin Pract 2021;75(10). Stewart I, Jacob J, George PM, et al. Residual Lung Abnormalities after COVID-19 Hospitalization: Interim Analysis of the UKILD Post-COVID-19 Study. Am J Respir Crit Care Med 2023;207(6):693-703.
• Pal R, Bhadada SK. COVID-19 and diabetes mellitus: An unholy interaction of two pandemics. Diabetes Metab Syndr 2020;14(4):513-517.
• Gąsecka A, Borovac JA, Guerreiro RA, et al. Thrombotic Complications in Patients with COVID-19: Pathophysiological Mechanisms, Diagnosis, and Treatment. Cardiovasc Drugs Ther 2021;35(2):215-229.
• Di Minno A, Ambrosino P, Calcaterra I, Di Minno MND. COVID-19 and Venous Thromboembolism: A Meta-analysis of Literature Studies. Semin Thromb Hemost 2020;46(7):763-771.
• Sultana J, Mazzaglia G, Luxi N, et al. Potential effects of vaccinations on the prevention of COVID-19: rationale, clinical evidence, risks, and public health considerations. Expert Rev Vaccines 2020;19(10):919-936.
• Thindwa D, Garcia Quesada M, Liu Y, et al. Use of seasonal influenza and pneumococcal polysaccharide vaccines in older adults to reduce COVID-19 mortality. Vaccine 2020;38(34):5398-5401.