https://doi.org/10.4081/monaldi.2022.2412
Post-COVID-19 sequelae of the respiratory system. A single-centre experience reporting the compromise of the airway, alveolar and vascular components
Submitted: August 18, 2022
Accepted: October 3, 2022
Published: October 11, 2022
Accepted: October 3, 2022
Abstract Views: 2193
PDF: 377
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
The long-term sequelae of COVID-19 have now become more common and appreciable. The SARS-CoV-2 virus can cause a variety of infectious and non-infectious pulmonary complications. The purpose of this study is to raise awareness about post-COVID-19 pulmonary sequelae, both infectious and non-infectious, in this geographical area. A retrospective study was conducted from July 1st 2020 to December 20th 2020. A total of 1200 patients were evaluated, with 83 suffering from post-COVID-19 pulmonary complications. The patients' mean age was 62 years (IQR 55-69), with 63 (75.9%) being male. The most common co-morbid illnesses were hypertension (49, 59%) and diabetes (45, 54.2%). The majority of them (37, 44.6%) had severe COVID-19, followed by critical COVID-19 (33, 39.8%). There was no statistically significant difference in recurrence of respiratory symptoms or duration of current illness between non-severe, severe, and critical COVID-19 patients. Non-infectious complications were observed in the majority of patients (n=76, 91.5%), including organizing pneumonia/ground glass opacities in 71 (88%) patients, fibrosis in 44 (55%), pulmonary embolism in 10 (12.5%), pneumomediastinum in 6 (7.4%) and pneumothorax in 7 (8.6%). Infective complications (25, 30.1%) included aspergillus infection in 10 (12.0%) and bacterial infection in 5 (8.47%), with more gram-negative infections and one patient developing Mycobacterium tuberculosis. Post COVID-19 mortality was 11 (13.3%). The long-term pulmonary sequelae of COVID-19 are not rare. Cryptogenic organizing pneumonia, ground glass opacities, and fibrosis were common post-COVID-19 sequelae in our patients. This necessitates frequent close monitoring of these patients in order to initiate early appropriate management and prevent further morbidity and eventual mortality.
Pakistan Government. COVID-19 Health advisory platform by Ministry of National Health Services Regulations & Coordination 2021. Available from: https://covid.gov.pk/stats/pakistan
Ojo AS, Balogun SA, Williams OT, Ojo O. Pulmonary fibrosis in COVID-19 survivors: Predictive factors and risk reduction strategies. Pulm Med 2020;2020:6175964.
DOI: https://doi.org/10.1155/2020/6175964
Wang F, Kream RM, Stefano GB. Long-term respiratory and neurological sequelae of COVID-19. Med Sci Monit 2020;26:e928996.
DOI: https://doi.org/10.12659/MSM.928996
Leask A. COVID-19: is fibrosis the killer? J Cell Commun Signal 2020;14:255.
DOI: https://doi.org/10.1007/s12079-020-00569-0
Kamal M, Abo Omirah M, Hussein A, Saeed H. Assessment and characterisation of post-COVID-19 manifestations. Int J Clin Pract 2021;75:e13746.
Hauguel-Moreau M, Hajjam ME, De Baynast Q, et al. Occurrence of pulmonary embolism related to COVID-19. J Thromb Thrombolysis 2021;52:69-75.
DOI: https://doi.org/10.1007/s11239-020-02292-4
George PM, Barratt SL, Condliffe R, et al. Respiratory follow-up of patients with COVID-19 pneumonia. Thorax 2020;75:1009–16.
DOI: https://doi.org/10.1136/thoraxjnl-2020-215314
Salehi M, Ahmadikia K, Badali H, Khodavaisy S. Opportunistic fungal infections in the epidemic area of COVID-19: A clinical and diagnostic perspective from Iran. Mycopathologia 2020;185:607–11.
DOI: https://doi.org/10.1007/s11046-020-00472-7
Vaillancourt M, Jorth P. The unrecognized threat of secondary bacterial infections with COVID-19. mBio 2020;11:e01806-20.
DOI: https://doi.org/10.1128/mBio.01806-20
Yang H, Lu S. COVID-19 and tuberculosis. J Transl Intern Med 2020;8:59–65.
DOI: https://doi.org/10.2478/jtim-2020-0010
Xiong Q, Xu M, Li J, Liu Y, Zhang J, Xu Y, et al. Clinical sequelae of COVID-19 survivors in Wuhan, China: a single-centre longitudinal study. Clin Microbiol Infect 2021;27:89–95.
DOI: https://doi.org/10.1016/j.cmi.2020.09.023
Carfì A, Bernabei R, Landi F Gemelli Against COVID-19 Post-Acute Care Study Group. Persistent symptoms in patients after acute COVID-19. JAMA 2020;324:603–5.
DOI: https://doi.org/10.1001/jama.2020.12603
No authors listed. Update to living WHO guideline on drugs for covid-19. BMJ 2022;376:o80.
DOI: https://doi.org/10.1136/bmj.o80
Esendağli D, Yilmaz A, Akçay MŞ, Özlü T. Post-COVID syndrome: pulmonary complications. Turk J Med Sci 2021;51:S3359-71.
DOI: https://doi.org/10.3906/sag-2106-238
Ali RMM, Ghonimy MBI. Post-COVID-19 pneumonia lung fibrosis: a worrisome sequelae in surviving patients. Egypt J Radiol Nucl Med 2021;52:101.
DOI: https://doi.org/10.1186/s43055-021-00484-3
Ahmed OF, Amin BJH, Abdullah BA, et al. Post COVID-19 pulmonary complications; a single center experience. Ann Med Surg 2021;72:103052.
DOI: https://doi.org/10.1016/j.amsu.2021.103052
Mandal S, Barnett J, Brill SE, et al. ‘Long-COVID’: a cross-sectional study of persisting symptoms, biomarker and imaging abnormalities following hospitalisation for COVID-19. Thorax 2021;76:396-8.
DOI: https://doi.org/10.1136/thoraxjnl-2020-215818
Nabahati M, Ebrahimpour S, Khaleghnejad Tabari R, Mehraeen R. Post-COVID-19 pulmonary fibrosis and its predictive factors: a prospective study. Egypt J Radiol Nucl Med 2021;52:248.
DOI: https://doi.org/10.1186/s43055-021-00632-9
Kamal M, Abo Omirah M, Hussein A, Saeed H. Assessment and characterisation of post‐COVID‐19 manifestations. Int J Clin Pract 2021;75:e13746.
DOI: https://doi.org/10.1111/ijcp.13746
McDonald LT. Healing after COVID-19: are survivors at risk for pulmonary fibrosis? Am J Physiol Lung Cell Mol Physiol 2021;320:L257-L65.
DOI: https://doi.org/10.1152/ajplung.00238.2020
Ghose M, Islam T. Facing the challenge of post COVID-19 pulmonary fibrosis: What is so unique about it? Bangladesh Crit Care J 2020;8:102-7.
DOI: https://doi.org/10.3329/bccj.v8i2.50028
Rai DK, Sharma P, Kumar R. Post covid 19 pulmonary fibrosis. Is it real threat? Indian J Tuberc 2021;68:330-3.
DOI: https://doi.org/10.1016/j.ijtb.2020.11.003
Li Y, Wu J, Wang S, et al. Progression to fibrosing diffuse alveolar damage in a series of 30 minimally invasive autopsies with COVID‐19 pneumonia in Wuhan, China. Histopathology 2021;78:542-55.
DOI: https://doi.org/10.1111/his.14249
Klok F, Kruip M, Van der Meer N, et al. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thromb Res 2020;191:145-7.
DOI: https://doi.org/10.1016/j.thromres.2020.04.013
Jandial A, Gupta A, Malviya A, Agastam S, Kumar D. Coagulation abnormalities & thromboprophylaxis in COVID-19. Indian J Med Res 2021;153:606-18.
DOI: https://doi.org/10.4103/ijmr.IJMR_3841_20
Vechi HT, Maia LR, Alves MdM. Late acute pulmonary embolism after mild Coronavirus Disease 2019 (COVID-19): a case series. Rev Inst Med Trop Sao Paulo 2020;62:e63.
DOI: https://doi.org/10.1590/s1678-9946202062063
Nauka PC, Oran E, Chekuri S. Deep venous thrombosis in a non-critically ill patient with novel COVID-19 infection. Thromb Res 2020;192:27.
DOI: https://doi.org/10.1016/j.thromres.2020.05.015
Brem FL, Rasras H, El Ouafi N, Bazid Z. Bilateral pulmonary embolism in patients recovered from asymptomatic COVID-19 infection. Cureus 2021;13:e13848.
Cuker A, Tseng EK, Nieuwlaat R, et al. American Society of Hematology living guidelines on the use of anticoagulation for thromboprophylaxis in patients with COVID-19: May 2021 update on the use of intermediate-intensity anticoagulation in critically ill patients. Blood Adv 2021;5:3951-9.
DOI: https://doi.org/10.1182/bloodadvances.2021005493
Sahagun J, Chopra A, David AG, et al. Secondary spontaneous pneumothorax in a COVID-19 recovered patient. Cureus 2021;13:e16415.
DOI: https://doi.org/10.7759/cureus.16415
Nunna K, Braun AB. Development of a large spontaneous pneumothorax after recovery from mild COVID-19 infection. BMJ Case Rep 2021;14:e238863.
DOI: https://doi.org/10.1136/bcr-2020-238863
Nasir N, Farooqi J, Mahmood SF, Jabeen K. COVID‐19‐associated pulmonary aspergillosis (CAPA) in patients admitted with severe COVID‐19 pneumonia: An observational study from Pakistan. Mycoses 2020;63:766-70.
DOI: https://doi.org/10.1111/myc.13135
Chong WH, Neu KP. The incidence, diagnosis, and outcomes of COVID-19-associated pulmonary aspergillosis (CAPA): a systematic review. J Hosp Infect 2021;113:115-29.
DOI: https://doi.org/10.1016/j.jhin.2021.04.012
Chong WH, Saha BK, Chopra A. Narrative review of the relationship between COVID-19 and PJP: does it represent coinfection or colonization? Infection 2021;491079-90.
DOI: https://doi.org/10.1007/s15010-021-01630-9
Romero-Duarte Á, Rivera-Izquierdo M, de Alba IG-F, et al. Sequelae, persistent symptomatology and outcomes after COVID-19 hospitalization: the ANCOHVID multicentre 6-month follow-up study. BMC Med 2021;19:129.
DOI: https://doi.org/10.1186/s12916-021-02003-7
How to Cite
Iqbal, Nousheen, Iffat Khanum, Muhammad Ali Ibrahim Kazi, Syeda Urooj Riaz, Uzzam Ahmed Khawaja, Safia Awan, Muhammad Irfan, Ali Bin Sarwar Zubairi, and Javaid Ahmed Khan. 2022. “Post-COVID-19 Sequelae of the Respiratory System. A Single-Centre Experience Reporting the Compromise of the Airway, Alveolar and Vascular Components”. Monaldi Archives for Chest Disease 93 (3). https://doi.org/10.4081/monaldi.2022.2412.
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