Can 1st and 6th month pulmonary function test follow-ups give an idea about the long-term respiratory effects of COVID-19 pneumonia?

SUMMARY OBJECTIVE: The aim of this study was to ascertain the long-term respiratory effects of COVID-19 pneumonia through pulmonary function tests in follow-ups at 1 and 6 months. METHODS: Our study was conducted between August 1, 2020 and April 30, 2021. At 1 month after discharge, follow-up evaluations, PFTs, and lung imaging were performed on patients aged above 18 years who had been diagnosed with COVID-19 pneumonia. In the 6th month, the PFTs were repeated for those with pulmonary dysfunction. RESULTS: A total of 219 patients (mean age, 49±11.9 years) were included. Pathological PFT results were noted in the 1st month for 80 patients and in the 6th month for 46 (7 had obstructive disorder, 15 had restrictive disorder, and 28 had small airway obstruction) patients. A significant difference was found between abnormal PFT results and patient-described dyspnea in the 1st month of follow-up. The 6-month PFT values (especially those for forced vital capacity) were statistically significantly lower in the patients for whom imaging did not indicate complete radiological improvement at the 1-month follow-up. No statistically significant difference was found between the severity of the first computed tomography findings or clinical condition on emergency admission and pulmonary dysfunction (Pearson's chi-square test, P=0.904; Fisher's exact test, P=0.727). CONCLUSION: It is important that patients with COVID-19 pneumonia be followed up for at least 1 month after discharge to be monitored for potential long-term lung damage. PFTs should be administered to those in whom ongoing dyspnea, which started with COVID-19, and/or full recovery were not identified in pulmonary imaging.

Evaluation of factors affecting the frequency and clinical course of COVID-19 in patients using anti-TNF-alpha agents

SUMMARY OBJECTIVES: Patients being treated with anti-tumor necrosis factor-alpha (anti-TNF-alpha) agents were reported to have better prognosis related to COVID-19. We evaluated the factors affecting the frequency, clinical course, and outcome of COVID-19 in patients treated with anti-TNF-alpha agents. METHODS: Patients with rheumatoid diseases and chronic inflammatory bowel diseases treated with anti-TNF-alpha agents were evaluated retrospectively. The laboratory data in routine visits, frequency of COVID-19, pneumonia, hospitalization and/or intensive care unit (ICU) follow-up and, mortality were recorded. The factors related to COVID-19 frequency and clinical outcome were evaluated. RESULTS: A total of 324 patients (177 males [54.6%] and 147 females [45.4%], mean age: 45.3±12.16 years) was included in the study. In all, 44 (13.6%) patients had COVID-19; of these, 11 (25%) developed pneumonia, 7 (15.9%) were hospitalized, and 1 (2.3%) was followed up in ICU. There was no mortality. The patients with COVID-19 pneumonia were older (mean age: 52±11 years versus 41±12 years, p=0.01), had hypertension and coronary artery disease more frequently (5 cases [55.6%] versus 4 cases [44.4], p=0.02 and 2 cases [100%] versus 0 cases [0%], p=0.014, respectively), and lower eosinophil % (1.35±1.79% versus 2.3±1.45%, p=0.016). The diabetes mellitus was more frequent (66.7 versus 33.3%, p=0.013), and mean eosinophil % was lower among inpatients compared with outpatients (1.29±2.22% versus 2.19±1.37%, p=0.02). CONCLUSIONS: We concluded that the patients treated with anti-TNF-alpha agents having COVID-19 might have mild clinical course and better prognosis.