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. 2021 Nov:188:106602.
doi: 10.1016/j.rmed.2021.106602. Epub 2021 Sep 8.

Complications after discharge with COVID-19 infection and risk factors associated with development of post-COVID pulmonary fibrosis

Dr Raminder Aul  1 , Dr Jessica Gates  2 , Dr Adrian Draper  2 , Dr Anne Dunleavy  2 , Dr Sachelle Ruickbie  2 , Dr Helen Meredith  2 , Dr Nicola Walters  2 , Dr Cristiano van Zeller  2 , Dr Victoria Taylor  2 , Dr Michael Bridgett  2 , Dr Roisin Dunwoody  2 , Dr Sisa Grubnic  2 , Dr Tersesa Jacob  2 , Dr Yee Ean Ong  2
Affiliations

Complications after discharge with COVID-19 infection and risk factors associated with development of post-COVID pulmonary fibrosis

Dr Raminder Aul et al. Respir Med. 2021 Nov.

Abstract

Introduction: Survivors of COVID-19 infection may develop post-covid pulmonary fibrosis (PCF) and suffer from long term multi-system complications. The magnitude and risk factors associated with these are unknown.

Objectives: We investigated the prevalence and risk factors associated with PCF and other complications in patients discharged after COVID-19 infection.

Methods: Patients had phone assessment 6 weeks post hospital discharge after COVID-19 infection using a set protocol. Those with significant respiratory symptoms were investigated with a CTPA, Pulmonary Function Tests and echocardiogram. Prevalence of myalgia, fatigue, psychological symptoms and PCF was obtained. Risk factors associated with these were investigated.

Results: A large number of patients had persistent fatigue (45.1%), breathlessness (36.5%), myalgia (20.5%) and psychological symptoms (19.5%). PCF was seen in 9.5% of the patients and was associated with persistent breathlessness at 6 weeks and inpatient ventilation [adjusted OR 5.02(1.76-14.27) and 4.45(1.27-15.58)] respectively. It was more common in men and in patients with peak CRP >171.5 mg/L, peak WBC count ≥12 × 10 9/L, severe inpatient COVID-19 CXR changes and CT changes. Ventilation was also a risk factor for persisting fatigue and myalgia, the latter was also more common in those with severe cytokine storm and severe COVID-19 inpatient CXR changes.

Conclusions: All the patients discharged after COVID-19 should be assessed using a set protocol by a multidisciplinary team. Patients who had severe COVID-19 infection particularly those who were intubated and who have persistent breathlessness are at risk of developing PCF. They should have a CT Chest and have respiratory follow-up.

Keywords: COVID-19; Long term complications of COVID-19; Post COVID Fibrosis.

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Conflict of interest statement

No Conflicts of interest for all authors.

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

No prior publication.

Figures

Fig. 1
Fig. 1
Flow chart Showing outcomes of patients admitted to our institution with COVID-19.
See this image and copyright information in PMC

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