Lung Function and Symptoms in Post–COVID-19 Patients
Objective: To address the lack of information about clinical sequelae of coronavirus disease 2019 (COVID-19). Patients and Methods: Previously hospitalized COVID-19 patients who were attending the outpatient clinic for post–COVID-19 patients (ASST Ovest Milanese, Magenta, Italy) were included in thi...
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doaj-1398a9510d2b4f91b1100f16df13926b2021-09-19T04:59:03ZengElsevierMayo Clinic Proceedings: Innovations, Quality & Outcomes2542-45482021-10-0155907915Lung Function and Symptoms in Post–COVID-19 PatientsNicola Mumoli, MD0Aldo Bonaventura, MD, PhD1Alessandra Colombo, MD2Alessandra Vecchié, MD3Marco Cei, MD4José Vitale, MD5Luca Pavan, MD6Antonino Mazzone, MD7Francesco Dentali, MD8Department of Internal Medicine, ASST Ovest Milanese, Magenta (MI), Italy; Correspondence: Address to Nicola Mumoli, MD, Department of Internal Medicine, Ospedale di Magenta, ASST Ovest Milanese, 20013 Magenta (MI), Italy.Department of Internal Medicine, ASST Sette Laghi, Varese, ItalyDepartment of Internal Medicine, ASST Ovest Milanese, Magenta (MI), ItalyDepartment of Internal Medicine, ASST Sette Laghi, Varese, ItalyDepartment of Internal Medicine, Cecina Hospital, Cecina (Livorno), ItalyDepartment of Internal Medicine, ASST Ovest Milanese, Magenta (MI), ItalyDepartment of Internal Medicine, ASST Ovest Milanese, Magenta (MI), ItalyDepartment of Internal Medicine, ASST Ovest Milanese, Magenta (MI), ItalyDepartment of Medicine and Surgery, Insubria University, Varese, ItalyObjective: To address the lack of information about clinical sequelae of coronavirus disease 2019 (COVID-19). Patients and Methods: Previously hospitalized COVID-19 patients who were attending the outpatient clinic for post–COVID-19 patients (ASST Ovest Milanese, Magenta, Italy) were included in this retrospective study. They underwent blood draw for complete blood count, C-reactive protein, ferritin, D-dimer, and arterial blood gas analysis and chest high-resolution computed tomography (HRCT) scan. The primary endpoint was the assessment of blood gas exchanges after 3 months. Other endpoints included the assessment of symptoms and chest HRCT scan abnormalities and changes in inflammatory biomarkers after 3 months from hospital admission. Results: Eighty-eight patients (n = 65 men; 73.9%) were included. Admission arterial blood gas analysis showed hypoxia and hypocapnia and an arterial partial pressure of oxygen/fractional inspired oxygen ratio of 271.4 (interquartile range [IQR]: 238-304.7) mm Hg that greatly improved after 3 months (426.19 [IQR: 395.2-461.9] mm Hg, P<.001). Forty percent of patients were still hypocapnic after 3 months. Inflammatory biomarkers dramatically improved after 3 months from hospitalization. Fever, resting dyspnea, and cough were common at hospital admission and improved after 3 months, when dyspnea on exertion and arthralgias arose. On chest HRCT scan, more than half of individuals still presented with interstitial involvement after 3 months. Positive correlations between the interstitial pattern at 3 months and dyspnea on admission were found. C-reactive protein at admission was positively associated with the presence of interstitial involvement at follow-up. The persistence of cough was associated with presence of bronchiectasis and consolidation on follow-up chest HRCT scan. Conclusion: Whereas inflammatory biomarker levels normalized after 3 months, signs of lung damage persisted for a longer period. These findings support the need for implementing post–COVID-19 outpatient clinics to closely follow-up COVID-19 patients after hospitalization.http://www.sciencedirect.com/science/article/pii/S2542454821001211 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Nicola Mumoli, MD Aldo Bonaventura, MD, PhD Alessandra Colombo, MD Alessandra Vecchié, MD Marco Cei, MD José Vitale, MD Luca Pavan, MD Antonino Mazzone, MD Francesco Dentali, MD |
spellingShingle |
Nicola Mumoli, MD Aldo Bonaventura, MD, PhD Alessandra Colombo, MD Alessandra Vecchié, MD Marco Cei, MD José Vitale, MD Luca Pavan, MD Antonino Mazzone, MD Francesco Dentali, MD Lung Function and Symptoms in Post–COVID-19 Patients Mayo Clinic Proceedings: Innovations, Quality & Outcomes |
author_facet |
Nicola Mumoli, MD Aldo Bonaventura, MD, PhD Alessandra Colombo, MD Alessandra Vecchié, MD Marco Cei, MD José Vitale, MD Luca Pavan, MD Antonino Mazzone, MD Francesco Dentali, MD |
author_sort |
Nicola Mumoli, MD |
title |
Lung Function and Symptoms in Post–COVID-19 Patients |
title_short |
Lung Function and Symptoms in Post–COVID-19 Patients |
title_full |
Lung Function and Symptoms in Post–COVID-19 Patients |
title_fullStr |
Lung Function and Symptoms in Post–COVID-19 Patients |
title_full_unstemmed |
Lung Function and Symptoms in Post–COVID-19 Patients |
title_sort |
lung function and symptoms in post–covid-19 patients |
publisher |
Elsevier |
series |
Mayo Clinic Proceedings: Innovations, Quality & Outcomes |
issn |
2542-4548 |
publishDate |
2021-10-01 |
description |
Objective: To address the lack of information about clinical sequelae of coronavirus disease 2019 (COVID-19). Patients and Methods: Previously hospitalized COVID-19 patients who were attending the outpatient clinic for post–COVID-19 patients (ASST Ovest Milanese, Magenta, Italy) were included in this retrospective study. They underwent blood draw for complete blood count, C-reactive protein, ferritin, D-dimer, and arterial blood gas analysis and chest high-resolution computed tomography (HRCT) scan. The primary endpoint was the assessment of blood gas exchanges after 3 months. Other endpoints included the assessment of symptoms and chest HRCT scan abnormalities and changes in inflammatory biomarkers after 3 months from hospital admission. Results: Eighty-eight patients (n = 65 men; 73.9%) were included. Admission arterial blood gas analysis showed hypoxia and hypocapnia and an arterial partial pressure of oxygen/fractional inspired oxygen ratio of 271.4 (interquartile range [IQR]: 238-304.7) mm Hg that greatly improved after 3 months (426.19 [IQR: 395.2-461.9] mm Hg, P<.001). Forty percent of patients were still hypocapnic after 3 months. Inflammatory biomarkers dramatically improved after 3 months from hospitalization. Fever, resting dyspnea, and cough were common at hospital admission and improved after 3 months, when dyspnea on exertion and arthralgias arose. On chest HRCT scan, more than half of individuals still presented with interstitial involvement after 3 months. Positive correlations between the interstitial pattern at 3 months and dyspnea on admission were found. C-reactive protein at admission was positively associated with the presence of interstitial involvement at follow-up. The persistence of cough was associated with presence of bronchiectasis and consolidation on follow-up chest HRCT scan. Conclusion: Whereas inflammatory biomarker levels normalized after 3 months, signs of lung damage persisted for a longer period. These findings support the need for implementing post–COVID-19 outpatient clinics to closely follow-up COVID-19 patients after hospitalization. |
url |
http://www.sciencedirect.com/science/article/pii/S2542454821001211 |
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