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Deprecated: Implicit conversion from float 267.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 ERJ+Open+Res 2021 ; 7 (1): ä Nephropedia Template TP
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Chest radiography is a poor predictor of respiratory symptoms and functional impairment in survivors of severe COVID-19 pneumonia #MMPMID33575312
D'Cruz RF; Waller MD; Perrin F; Periselneris J; Norton S; Smith LJ; Patrick T; Walder D; Heitmann A; Lee K; Madula R; McNulty W; Macedo P; Lyall R; Warwick G; Galloway JB; Birring SS; Patel A; Patel I; Jolley CJ
ERJ Open Res 2021[Jan]; 7 (1): ä PMID33575312show ga
Background: A standardised approach to assessing COVID-19 survivors has not been established, largely due to the paucity of data on medium- and long-term sequelae. Interval chest radiography is recommended following community-acquired pneumonia; however, its utility in monitoring recovery from COVID-19 pneumonia remains unclear. Methods: This was a prospective single-centre observational cohort study. Patients hospitalised with severe COVID-19 pneumonia (admission duration ?48?h and oxygen requirement ?40% or critical care admission) underwent face-to-face assessment at 4?6?weeks post-discharge. The primary outcome was radiological resolution of COVID-19 pneumonitis (Radiographic Assessment of Lung Oedema score <5). Secondary outcomes included clinical outcomes, symptom questionnaires, mental health screening (Trauma Screening Questionnaire, seven-item Generalised Anxiety Disorder assessment and nine-item Patient Health Questionnaire) and physiological testing (4-m gait speed (4MGS) and 1-min Sit-to-Stand (STS) tests). Results: 119 patients were assessed between June 3, 2020 and July 2, 2020 at median (interquartile range (IQR)) 61 (51?67)?days post-discharge: mean±sd age 58.7±14.4?years, median (IQR) body mass index 30.0 (25.9?35.2)?kg·m?2, 62% male and 70% ethnic minority. Despite radiographic resolution of pulmonary infiltrates in 87%, modified Medical Research Council Dyspnoea (breathlessness) scale grades were above pre-COVID-19 baseline in 44%, and patients reported persistent fatigue (68%), sleep disturbance (57%) and breathlessness (32%). Screening thresholds were breached for post-traumatic stress disorder (25%), anxiety (22%) and depression (18%). 4MGS was slow (<0.8?m·s?1) in 38% and 35% desaturated by ?4% during the STS test. Of 56 thoracic computed tomography scans performed, 75% demonstrated COVID-19-related interstitial and/or airways disease. Conclusions: Persistent symptoms, adverse mental health outcomes and physiological impairment are common 2?months after severe COVID-19 pneumonia. Follow-up chest radiography is a poor marker of recovery; therefore, holistic face-to-face assessment is recommended to facilitate early recognition and management of post-COVID-19 sequelae.