Indian Journal of Respiratory Care

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VOLUME 12 , ISSUE 1 ( January-March, 2023 ) > List of Articles

Original Article

Profile of COVID-19 Patients with Persistent Respiratory Symptoms

PV Harsha, Durga Balagopalan, MM Aneesh, Ponneduthamkuzhy Thomas James, Ajit Bhaskar, S Krishnaveni

Keywords : Computed tomography, COVID-19, Organizing pneumonia, Oxygen saturation

Citation Information : Harsha P, Balagopalan D, Aneesh M, James PT, Bhaskar A, Krishnaveni S. Profile of COVID-19 Patients with Persistent Respiratory Symptoms. Indian J Respir Care 2023; 12 (1):55-58.

DOI: 10.5005/jp-journals-11010-1010

License: CC BY-NC-SA 4.0

Published Online: 14-03-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Background and objective: COVID pandemic struck the entire world causing high mortality and morbidity. After-effects of the infection were manifested in various clinical forms for the varying duration. As the pandemic waxes and wanes, COVID has become one of the differential diagnoses for various clinical and radiological pictures and triggers for respiratory diseases. While COVID sequelae are still much to explore, this study aimed to assess the clinicoradiological profile of COVID-19 patients who have persistent symptoms pertaining to the respiratory system. Materials and methods: This prospective study was conducted for 1 year from December 2020 to December 2021. COVID-19 patients aged between 10 and 85 years with persistent respiratory symptoms were included in this study. Results: There were a total of 90 patients. The mean age was 50.79 years. Forty-eight (53.3%) patients were males and 42 (46.7%) were females. Among these patients, eight patients (8.9%) had an asymptomatic or minimal symptomatic gap of at least 2 weeks from the date of positivity to the development of full-blown symptoms. The maximum duration of symptoms reported was more than 1 year and continuing. Dyspnea on exertion was the predominant symptom, in 59 patients (65.6%). Hypoxia at rest was seen in 35 (38.9%) patients, whereas seven patients with normal oxygen saturation showed exertional desaturation. Out of the 33 patients with post-COVID changes in computed tomography (CT) of the thorax, ground-glass opacities were seen in all 33 patients (100%), consolidation in 18 patients (54.5%), septal thickening in 18 patients (54.5%), and fibrosis in 15 patients (45.4%). Predominant CT finding was that of organizing pneumonia, but a few had fibrotic picture similar to usual interstitial pneumonia (UIP) or fibrotic nonspecific interstitial pneumonia (fibrotic NSIP). Hypoxia severity was significantly associated with diabetes (p = 0.028), hypertension (p = 0.028), chronic kidney disease (p = 0.027), chronic obstructive pulmonary disease (p = 0.001), obesity (p = 0.000), and smoking (p = 0.004). CT severity scoring was significantly associated with hypoxia severity. Conclusion: After the initial weeks, COVID patients can present with varying respiratory symptoms. They can present with respiratory failure as late as 1 month after the test positivity. Although CT picture was predominantly that of organizing pneumonia, COVID lung sequelae can masquerade as UIP or fibrotic NSIP as in idiopathic pulmonary fibrosis and connective tissue disease-associated interstitial lung disease, whereas atypical infections and malignancy can masquerade as COVID lung. Irreversible changes like honeycombing can occur as early as 2nd month after COVID.

  1. Carfì A, Bernabei R, Landi F, et al. Persistent symptoms in patients after acute COVID-19. JAMA 2020;324:603–605. DOI: 10.1001/jama.2020.12603
  2. Menges D, Ballouz T, Anagnostopoulos A, et al. Burden of post-COVID-19 syndrome and implications for healthcare service planning: a population-based cohort study. PLoS One 16(7):e0254523. DOI: 10.1371/journal.pone.0254523
  3. Asleh R, Asher E, Yagel O, et al. Predictors of hypoxemia and related adverse outcomes in patients hospitalized with COVID-19: a double-center retrospective study. J Clin Med 2021;10:3581. DOI: 10.3390/jcm10163581
  4. Sudre CH, Murray B, Varsavsky T, et al. Attributes and predictors of long COVID. Nat Med 2021;27:626–631. DOI: 10.1038/s41591-021-01292-y
  5. Rai DK, Thakur S. Study to identify predictor of hypoxia in COVID-19 infection: a single-center, retrospective study. J Family Med Prim Care 2021;10(5):1852–1855. DOI: 10.4103/jfmpc.jfmpc_2252_20
  6. Diendéré EA, Sondo KA, Ouédraogo AR, et al. Predictors of severe hypoxemia among COVID-19 patients in Burkina Faso (West Africa): findings from hospital based cross-sectional study. Int J Infect Dis 2021;108:289–295. DOI: 10.1016/j.ijid.2021.04.007
  7. Zhao X, Gang X, He G, et al. Obesity increases the severity and mortality of influenza and COVID-19: a systematic review and meta-analysis. Front Endocrinol (Lausanne) 2020;11:595109. DOI: 10.3389/fendo.2020.595109
  8. Duzgun SA, Durhan G, Demirkazik FB, et al. COVID-19 pneumonia: the great radiological mimicker. Insights Imaging 2020;11:118. DOI: 10.1186/s13244-020-00933-z
  9. Wang Y, Jin C, Wu CC, et al. Organizing pneumonia of COVID-19: Time-dependent evolution and outcome in CT findings. PLoS One 15(11):e0240347. DOI: 10.1371/journal.pone.0240347
  10. Faria IM, Zanetti G, Barreto MM, et al. Organizing pneumonia: chest HRCT findings. J Bras Pneumol 2015;41:231–237. DOI: 10.1590/S1806-37132015000004544
  11. Saeed GA, Gaba W, Shah A, et al. Correlation between chest CT severity scores and the clinical parameters of adult patients with COVID-19 pneumonia. Radiol Res Pract 2021;2021:6697677. DOI: 10.1155/2021/6697677
  12. Combet M, Pavot A, Savale L, et al. Rapid onset honeycombing fibrosis in spontaneously breathing patient with COVID-19. Eur Respir J 2020;56(2): DOI: 10.1183/13993003.01808-2020
  13. Sharifipour E, Shams S, Esmkhani M, et al. Evaluation of bacterial co-infections of the respiratory tract in COVID-19 patients admitted to ICU. BMC Infect Dis 2020;20:646. DOI: 10.1186/s12879-020-05374-z
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