Evaluation of 3‐month follow‐up of patients with postacute COVID‐19 syndrome

• Published in: Journal of medical virology Vol. 94; no. 5; pp. 2026 - 2034
• Main Authors: Kerget, Buğra, Çelik, Eda, Kerget, Ferhan, Aksakal, Alperen, Uçar, Elif Yılmazel, Araz, Ömer, Akgün, Metin
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.05.2022; John Wiley and Sons Inc
• Subjects: Alveoli; Carbon monoxide; Cell activation; COVID-19; COVID-19 - diagnosis; Dimers; Dyspnea; Evaluation; Follow-Up Studies; Forced Expiratory Volume; Heart rate; Humans; Infections; Laboratories; Lactose; Lung - diagnostic imaging; Lungs; Macrophages; Methylprednisolone; Outpatient care facilities; Parameters; Patients; Pneumonia; Polymerase chain reaction; postacute COVID‐19; pulmonary function test; Pulmonary functions; radiological sign; Respiration; Respiratory failure; Respiratory function; Respiratory Function Tests; Signs and symptoms; Virology; pulmonary function test; radiological sign; postacute COVID-19
• ISSN: 0146-6615; 1096-9071
• DOI: 10.1002/jmv.27579

In addition to the highly variable clinical presentation of acute COVID‐19 infection, it can also cause various postacute signs and symptoms. This study aimed to evaluate patients with postacute COVID‐19 over 12 weeks of follow‐up. The study included 151 patients who were diagnosed with COVID‐19 by real‐time polymerase chain reaction of a nasopharyngeal swab 1 month earlier, had radiologic findings consistent with COVID‐19 pneumonia, and presented to the post‐COVID‐19 outpatient clinic between May and August 2021. The patients were divided into three groups based on COVID‐19 severity: nonsevere pneumonia (Group 1), severe pneumonia (Group 2), and severe pneumonia requiring intensive care (Group 3). Evaluation of laboratory parameters at 4 and 12 weeks showed that Group 3 had a higher lactose dehydrogenase (LDH) level and a lower mean platelet volume than the other groups at both time points (p = 0.001 for all). Group 3 also had lower percent predicted forced vital capacity (FVC%), percent predicted forced expiration volume in 1 s (FEV1%), and percent predicted diffusion capacity of the lungs for carbon monoxide divided by alveolar volume (DLCO/VA%) compared to Groups 1 and 2 at Week 4 (p = 0.001, 0.004, 0.001, respectively) and compared to Group 1 at 12 weeks (p = 0.002, 0.03, 0.001, respectively). Patients with persistent dyspnea at 12 weeks had significantly lower FEV1%, FVC%, DLCO/VA%, and saturation levels in room air and significantly higher LDH, pro‐BNP, D‐dimer, and heart rate compared to those without dyspnea (p = 0.001 for all). Although the lungs are most commonly affected after COVID‐19 infection, vascular and endothelial damage also causes multisystem involvement. Our study indicates that laboratory values, radiological signs, and pulmonary functional capacity improved in most patients after 12 weeks of follow‐up. Highlights In the present study, we aimed to examine changes in clinical symptoms, laboratory parameters, and pulmonary function tests over 12 weeks of follow‐up in patients presenting to our COVID‐19 outpatient clinic due to postacute COVID‐19 syndrome. The results of our study demonstrated significant regression in patients' postacute symptoms and radiological signs at 12 weeks. In addition, we observed that the decrease in pulmonary function parameters at 4 weeks in patients who developed macrophage activation syndrome and respiratory failure largely resolved and approached normal limits with follow‐up alone or methylprednisolone therapy administered based on individual patient assessment.