COVID-19 Course in Recovered Patients Evaluation by Clinical, Radiological and Pulmonary Function Parameters

Abstract

Introduction: As of December 2020, the Coronavirus- 2019 (COVID -19) pandemic has affected over 70 million people and caused over 1.6 million deaths worldwide. However, the long term effects of COVID-19 are still unclear, and very limited data in this regard is available. Both persistent pulmonary and extra-pulmonary manifestations and their relationship to initial disease severity are unclear. Methods: This is a prospective cohort single centre study, performed at Hadassah Medical centre, Jerusalem, Israel. Patients admitted due to COVID-19 were invited to a clinic visit for follow up 4-12 weeks after acute infection. Clinical, radiological and pulmonary function parameters were evaluated according to the initial disease severity: mild, moderate and severe. Results: 98 patients included in the analysis. Mean age was 47.5±14.5 years, 48% were male.34.7% had an abnormal chest x-ray at presentation (CXR). After a follow-up period of 4-12 weeks, the majority of patients (90.8%) still has residual symptoms, with dyspnea and fatigue being the most common symptoms in 54.1% and 57.1%, respectively. Other common symptoms included cough (21.4%), arthralgia (27.6%), memory disturbance or concentration difficulties (31.6%). No significant difference was observed in the frequency of residual symptoms between patients with initial mild, moderate or severe disease. Mean forced vital capacity was 91% of predicted. There was no significant difference between groups of patients in forced expiratory volume at 1 second (FEV1), FVC, or the ratio FEV1/FVC. At the follow-up visit, 18 (18.3%) and 14 (14.2%) patients had abnormal CXR and computerized tomography respectively. Conclusion: The large majority of patients who have COVID-19 infection suffer from prolonged residual symptoms. In contrast, significant abnormalities on spirometry or imaging studies are uncommon. In our cohort, we found no significant difference in the frequency of post-COVID symptoms in patients with the initial mild, moderate or severe initial disease.