Initial severity of COVID-19 not linked to later poor health

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In a new study, researchers examined the recovery of lung function and overall wellness in individuals who had varying degrees of COVID-19 severity.

They found that fatigue, ill-health and breathlessness were all common following COVID-19.

However, these symptoms appeared to be unrelated to the severity of the initial infection or any single measurement at the time of an outpatient appointment.

Little is known about lung health following infection with SARS-CoV-2, the virus that causes COVID-19, and whether later respiratory problems, fatigue and ill health are linked to the disease’s initial severity.

In the study, the team looked at a number of measures of recovery for 153 patients who were followed in an outpatient clinic a median of 75 days after their COVID-19 diagnoses.

They graded the patients’ initial infection severity as: (1) not requiring admission; (2) requiring hospital admission, or (3) requiring ICU care. Nearly half (74) of these patients required hospital admission during acute infection.

The researchers examined the association between the patients’ initial illness and abnormal chest x-ray, six-minute walk test distance—in which patients walked at their normal pace for six minutes—and perception of maximal exertion during their follow-up appointments.

Patients were also asked about whether they felt fatigued and whether they thought they had returned to full health.

The findings suggest that COVID-19 does not cause significant fibrosis, with lung scarring seen on CT scans of only 4 percent of study participants, following x-ray detection of earlier abnormalities in a larger group.

62% of patients felt they had not returned to full health, while 47% were classified as having fatigue.

Patients who felt they had to exert themselves during moderate exercise also reported they felt fatigued and in poor health.

Patients’ length of inpatient hospital stays and frailty were linked to covering less distance in the walk test.

The team says these findings have implications for clinical care, in that they demonstrate the importance of following up with all patients who were diagnosed with COVID-19, irrespective of the severity of the initial infection.

One author of the study is Liam Townsend, M.D.

The study is published in the Annals of the American Thoracic Society.

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