Post COVID-19 lung sequelae: Six month follow up study at a tertiary institute

ABSTRACT

Background: COVID-19 pandemic has been an unprecedented health crisis. Post COVID-19 lung sequelae comprise respiratory disease occurring after recovery from COVID-19. Objective: (1) To determine the baseline characteristics. (a) Inflammatory marker levels. (b) Spirometric values. (c) 6 minute walk distance. (d) Radiological parameters. (2) To assess the differences in above mentioned parameters, during follow up. Methods: All consecutive recovered patients of moderate to severe COVID-19 attending Post COVID-19 clinic were subjected to history taking of grade of dyspnea and preexisting co morbidities. At baseline visit, inflammatory markers (ESR, CRP, d-Dimer, Ferritin and LDH), Spirometry, 6MWD and HRCT thorax findings were determined. Spirometry and 6MWD were repeated in follow up visits (0, 3, 12, 24 weeks). Results: Of the 468 patients, 196 (41.9%) had moderate and 272 (58.1%) had severe disease. Ever smokers comprised 58 (16.2%) patients. 348 (74.3%) had comorbidities, most common being hypertension (192, 41%). The mean value of ESR, CRP, d-Dimer, LDH and Ferritin levels was higher in severe patient group, compared to moderate patient group (although statistically insignificant). Statistically significant decline was seen in ESR, CRP, ferritin and LDH levels in 1st follow up. Spirometric parameter, absolute FVC was higher in moderate group compared to severe group and statistically significant. Most common radiological finding was ground glass opacity (GGO), and treated with OCS. In OCS treatment arm, statistically significant increment in 6MWD was seen as compared to antifibrotic arm. Conclusion: Long recovery period should be expected in patients of moderate to severe COVID-19.