ABSTRACT
IntroductionOne in ten people will develop Long COVID (LC) following infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Despite broad-ranging and episodic symptomology, there are no data that demonstrate changes in functional status (FS), respiratory muscle strength and lung function over time. We conducted a sixteen-week cohort observation of LC patients to determine changes in FS, respiratory muscle strength and lung function.MethodSixty-six patients (n=48 females, mean age 51 ± 10 years, n=8 hospitalised, mean time post-infection 6.2 ± 1.8 months) were recruited from LC clinics in the United Kingdom (CPMS ID: 52331). Patients completed five face-to-face visits (day 0, 28, 56, 84 and 110 ± 3 days) and bi-weekly telephone consultations (day 14, 42, 70 and 98 ± 3 days). FS was assessed via the post-COVID functional status scale (PCFS) and the six-minute walk test (6MWT). Maximum inspiratory (MIP) and expiratory (MEP) respiratory muscle pressure and lung function (forced vital capacity (FVC) and forced expired volume in one second (FEV1) were assessed during face-to-face visits according to published standards.ResultsPCFS was 2.7 ± 0.4 AU, P=0.02 at baseline and improved at 16-weeks (2.1 ±1.1 AU) and still highlighted impaired FS. 6MWT was 322 ± 133 meters at baseline and improved at 16 weeks (430 ± 150 meters, P<0.01) but remained lower than normative values for healthy age-matched controls. MIP was 77 ± 21 cmH2O at baseline (86% predicted) and was unchanged post 16 weeks (88 ± 25 cmH2O, 92% predicted, P>0.05). Baseline MEP was 115 ± 41 cmH2O (96% and was unchanged post-16-weeks (119 ± 48 cmH2O, 92% predicted, P>0.05). Lung function data were below predicted values and unchanged over 16 weeks (baseline FVC: 3.10 ± 0.53 L.s-1, 72% predicted, post 16 weeks: 3.16 ± 0.34 L.s-1, 73% predicted, P>0.05 and baseline FEV1: 2.68 ± 0.39 L.s-1, 85% predicted, post 16 weeks: 2.75 ± 0.36 L.s-1, 85% predicted).ConclusionLC patients demonstrate reduced respiratory muscle strength and lung function which could be associated with reduced FS and should be addressed via specific rehabilitation approaches.Please refer to page A216 for declarations of interest related to this .
ABSTRACT
OBJECTIVES: The COVID-19 pandemic caused an unprecedented health crisis resulting in over 6 million deaths worldwide, a figure, which continues to grow. In addition to the excess mortality, there are individuals who recovered from the acute stages, but suffered long-term changes in their health post COVID-19, commonly referred to as long COVID. It is estimated there are currently 1.8 million long COVID sufferers by May 2022 in the UK alone. The aim of this narrative literature review is to explore the signs, symptoms and diagnosis of long COVID and the potential impact on imaging services. KEY FINDINGS: Long COVID is estimated to occur in 9.5% of those with two doses of vaccination and 14.6% if those with a single dose or no vaccination. Long COVID is defined by ongoing symptoms lasting for 12 or more weeks post acute infection. Symptoms are associated with reductions in the quality of daily life and may involve multisystem manifestations or present as a single symptom. CONCLUSION: The full impact of long COVID on imaging services is yet to be realised, but there is likely to be significant increased demand for imaging, particularly in CT for the assessment of lung disease. Educators will need to include aspects related to long COVID pathophysiology and imaging presentations in curricula, underpinned by the rapidly evolving evidence base. IMPLICATIONS FOR PRACTICE: Symptoms relating to long COVID are likely to become a common reason for imaging, with a particular burden on Computed Tomography services. Planning, education and updating protocols in line with a rapidly emerging evidence base is going to be essential.