ABSTRACT
Introduction: The impact of prolonged covid illness has been devastating for many people worldwide. Aim(s): We analysed the characteristics of patients referred to our Long Covid clinic. Method(s): Preliminary data;retrospective analysis from electronic and paper case notes. Result(s): 317 patients were included;majority were female (68%) & white (83%). Median age was 49 years (range 16-86 yrs). Wide range of symptoms experienced, most commonly fatigue & dyspnoea. 74% of patients were not admitted to hospital with their original covid illness. Majority had only 1-2 long term medical comorbidities. 43% had a history of previous/current mental health illness. Lung function results showed mild asthma (13%), significant asthma (6%), ILD (3%) and were normal in 63%. 41% had potentially treatable causes for fatigue (e.g. low Vitamin D or hypothyroidism). 82% of patients were referred to rehabilitation and physiotherapy for fatigue and/or breathing pattern disorder. The mean Body Mass Index (BMI) was 30, with 30% of patients overweight, 38.5% obese and 9% morbidly obese. 28% had abnormal overnight oximetry - 16% were mild and 4% severe. Conclusion(s): Long covid has predominantly affected young, middle-aged white women. We have noted many patients with high BMI, previous mental illness, breathing pattern disorder, asthma and abnormal overnight oximetry. More than 80% needed rehabilitation, physiotherapy and psychological support. More data is being collected.
ABSTRACT
Introduction: We set out to look at the role of chest x-ray (CXR) in diagnosing novel coronavirus (Covid19) infection and to explore if it can predict clinical outcomes. We compared the chest imaging and swab results in Covid19 patients. Demographics, symptoms and CXR findings were explored as predictors of clinical outcome in COVID19 patients. Methods: All adult patients who had CXR and Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) available between March and June 2020 were included. Data was collected retrospectively from electronic case notes. CXR reported as typical or atypical COVID features1 was considered as positive. For predictors of outcomes, regression analysis was conducted. Results: 876 patients had both CXR and RT-PCR swabs. Their mean age was 64.6 years and age range was 17 to 105 years. 324 (37%) were positive and 552 (63%) negative on RT-PCR. CXR showed typical COVID19 changes in 217 (24.8%) and atypical COVID19 changes in 148 (16.9%) patients. The sensitivity and specificity of CXR in the overall study group was 59.9% and 69% with positive predictive value (PPV) and negative predictive value (NPV) of 53.2% and 74.6% respectively. 692 patients were admitted and the sensitivity and specificity of CXR in this group was 66.9% and 65.5% with PPV and NPV of 53% and 77.4% respectively. 148 patients (16.8%) received ventilator support (27 received invasive and 121 had non-invasive ventilator support) and the sensitivity and specificity of CXR in this sub-group was 78% and 42.4% with PPV and NPV of 62.7% and 60.9%. There were 129 deaths and on multivariate regression analysis, age (> 60 years) and positive CXR remained significant risk factors for the clinical outcome (Table). In contrast to the current literature, our sample did not show gender as a risk factor to predict the outcome. Conclusions: CXR has a reasonable specificity and sensitivity for diagnosing COVID19 and it increases with the severity especially in patients needing ventilator support. CXR can be used in predicting worse clinical outcome in COVID19 pneumonia.