Respiratory Outcomes in COVID-19 patients 3-6 months after admission to Public Health Hospital Maciel. Montevideo, Uruguay. A Follow up Cohort Study

To date, millions of people worldwide have recovered from COVID19, but concern remains on long-term impairment. We aimed to determine 3-6 months respiratory outcomes in a Latin American Public Health Hospital. Method(s): COVID-19 patients referred (April-June 2021,gamma variant breakdown) were enrolled, recalling epidemiology, demographic, comorbidities, laboratory, radiology, treatment and outcomes, performing spirometry, lung volumes, diffusing capacity (DLCO), walking test (6MWT);values< 80% of predicted were considered abnormal. Logistic regression analysis were performed to evaluate covariates associated with DLCO abnormality. Result(s): 56 patients followed 6 months make up the cohort. 56,9 +/- 13,0 years, 58,9% female,46,4% ever smokers, 42,9% obesity (BMI >30), 37,5% hypertension, 23,2% diabetes, 16,1% heart disease, 16,1% asthma. 64% dyspnea (MRC>1), 50% fatigue, sit to stand Sp02% 94,7 +/- 3,9. Lymphocites103 /muL 413,3 +/- 625,7,D-dimer ng/ml 3050,9 +/-7226,1,ferritin ng/ml 641,8 +/- 1173,4, 21.4% radiology abnormality, 35.7% admitted to ICU, days stay 17,1 +/- 10,5. 3 vs 6 months: TLC 5,3 +/- 1,9 vs 5,16 +/- 2,3 p=0.05;FVC 3,10 +/- 0,9 vs 3,16 +/- 1,0 p=0.04;DLCO:17,2 +/- 6,0 vs 17,8 +/- 6,2 7 p=0.006;Sp02% in 6MWT 90,1 +/- 98,2 vs 91,1 +/- 3,6 p=0.05. 6 months: dyspnea 28.6%, fatigue 26.8%, abnormality in: FVC 12,5%,FEV1 16,1%,DLCO 58,9%,distance 6MW 28,6%. Abnormal DLCO correlations: age > 65 p=0.02,smoking p=0.04,heart disease p=0.04,dyspnea MRC>1 p=0.002, persistent fatigue p=0.05. Conclusion(s): At 6 months some COVID-19 patients maintain symptoms and impaired DLCO and are the main target for further follow up and intervention.

Recommendations for the respiratory follow-up of patients with pulmonary complications due to COVID-19: Chair of Pulmonology, Faculty of Medicine, UDELAR Uruguayan Society of Pulmonology. (Pautas nacionales para la atenci..n de pacientes adultos con COVID-19.) [Spanish]

The objectives of this study were to Identify patients who require follow-up to prevent and treat medium- and long-term pulmonary sequelae of COVID-19. Based on the analysis of this evidence and the SEPAR (17), BTS (18) and NICE Guidelines (19) Consensus Guidelines, the following recommendations were drawn up with the aim of providing criteria for the clinical management of this new respiratory entity associated with SARS-CoV-2 infection.