Is acute phase severity predictive of long-covid-19 development?

ABSTRACT

Premise Pulmonary involvement by COVID-19 is almost constant;even in many pts cured from the acute phase (interstitial pneumonia) respiratory symptoms and signs persist (dyspnea, cough, desaturation, respiratory failure) and from pneumonia it passes to interstitial disease (ground-glass) and from there to pulmonary fibrosis (honeycomb lung). Objective of the study We asked whether the severity of the acute phase is matched by an equally severe long covid (LC). As indicators of severity, we used the minimum p/F at onset and the extent of disease at chest CT. Method(s) To consecutively evaluate all pts recovered from the acute phase of COVID-19 who presented to the pulmonology outpatient clinic with urgent referral from May 30, 2020, to January 31, 2022. Result(s) 314 outpts, mean age 62.3 years, 142 women, 172 men, with urgent request, for pulmonary examination and treated on an outpt basis presented a picture of LC with persistent lung lesions at 2 and 6 months respectively in 100% (66 at echo-thorax and 248 at chest CT) and 78.34% (246 pts) of the subjects. Of these compared with p/F < 100 27 pts 8.6% 101-200 97 pts 30.8% 201-300 103 pts 32.8% >300 87 pts 27.7% (p/F 127 severe, 103 average, and 87 normal) Discussion From these data, it appears that severity of COVID-19 disease is not a predictor for the development of LC. Conclusion(s) Further study are needed to identify what elements may be used to identify predictor for LC. Possible among these may be not having been treated with steroid in the cytokine phase, low vitamin D values, pre-existence of pulmonary fibrosis or interstitial disease, pre-existence of lung lesions in former smokers, obesity, diabetes, hypertension.