Lung function and symptoms in post-COVID-19 patients: a single-center experience

Mumoli, Nicola; Bonaventura, Aldo; Colombo, Alessandra; Vecchié, Alessandra; Cei, Marco; Vitale, José; Pavan, Luca; Mazzone, Antonino; Dentali, Francesco

Objective To address the lack of information about clinical sequelae of coronavirus disease 2019 (COVID-19). Patients and Methods Previously hospitalized COVID-19 patients who were attending the outpatient clinic for post-COVID-19 patients (ASST Ovest Milanese, Magenta, Italy) were included in this retrospective study. They underwent blood draw for complete blood count, C-reactive protein (CRP), ferritin, D-dimer, and arterial blood gas analysis (ABG) and chest high-resolution computed tomography (HRCT) scan. The primary endpoint was the assessment of blood gas exchanges after 3 months. Other endpoints included the assessment of symptoms and chest HRCT scan abnormalities and changes in inflammatory biomarkers after 3 months from hospital admission. Results Eighty-eight patients (men 73.9%) were included. Admission arterial ABG analysis showed hypoxia and hypocapnia and a PaO2/FiO2 of 271.4 (238-304.7) mmHg, that greatly improved after 3 months (426.19 [395.24-461.90] mmHg, P<.001). A 40% of patients was still hypocapnic after 3 months. Inflammatory biomarkers dramatically improved after 3 months from hospitalization. Fever, resting dyspnea, and cough were common at hospital admission and improved after 3 months, when dyspnea on exertion and arthralgias arose. On chest HRCT scan, more than half of individuals still presented interstitial involvement. Positive correlations between the interstitial pattern at 3 months and dyspnea on admission were found. CRP at admission was positively associated with the presence of interstitial involvement at follow-up. The persistence of cough was associated with presence of bronchiectasis and consolidation on follow-up chest HRCT scan. Conclusion While inflammatory biomarker levels normalized after 3 months, signs of lung damage persist for a longer period. These findings support the need for implementing post-COVID-19 outpatient clinics to closely follow-up COVID-19 patients after hospitalization.