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The coronavirus pandemic has spread around the world, infecting at least 27.1 million people and claiming more than 883,000 lives. More than 18 million have already recovered, but some patients report long-term effects on their organs.
Now, a team of researchers from the University Clinic of Innsbruck in Austria has found that long-term lung and heart damage in patients with coronavirus disease (COVID-19) who recovered tend to improve over time.
Presented at the International Congress of the European Respiratory Society, The study evaluated whether patients with long-term lung and heart damage they experience after being infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19 disease, will improve.
The researchers, who presented their study findings at the virtual conference, reported on the first 86 patients who were enrolled between April and June. The study has more than 150 patients participating to determine what happens after recovering from the infectious pathogen.
COVID-19 patient undergoing muscle training for rehabilitation. Image credit: Dieulefit Santé pulmonary rehabilitation center
Persistent COVID-19 symptoms
The team scheduled the patients to return for evaluation at 12 and 24 weeks after being discharged from the hospital. The team evaluated the patients’ conditions through clinical examinations, laboratory tests, CT scans, cardiac echocardiograms (ECGs), and analysis of the amounts of oxygen and carbon dioxide in arterial blood.
At six weeks, the researchers found that 65.9 percent of the patients manifested persistent COVID-19 symptoms, such as coughing and shortness of breath. About 88 percent of the study population had lung damage on the results of the CT scan. However, by the time of his next visit, 12 weeks after discharge, the symptoms had improved and the lung damage was down to 56 percent.
Getting better over time
More than half of the discharged patients reported persistent cough and dyspnea. At the 12-week visit, patients reported improvement in symptoms, such as less shortness of breath. About 39 percent reported still having trouble breathing and 15 percent still coughing.
The team evaluated lung function, which included FEV1, which measures how much air can be forcefully exhaled in one second, DLCO, which tests how well oxygen passes from the lungs into the bloodstream, and FCV, which measures the total volume of air expelled by the force.
All of these measurements improved between the six to 12 week follow-ups. At six weeks, 23 percent of the patients showed FEV1 levels below 80 percent of normal, with 21 percent of the patients improving at 12 weeks. About 28 percent of the patients showed FVC levels below 80 percent of normal, improving 16 patients or 19 percent. Additionally, 28 of the patients showed DLCO as less than 80 percent of normal, which improved to 19 patients at 12 weeks.
“The bad news is that people show lung deterioration from COVID-19 weeks after discharge; the good news is that the deterioration tends to improve over time, suggesting that the lungs have a mechanism to repair themselves,” said Dr. Sabina Sahanic, who is a clinical doctoral student at the University Clinic in Innsbruck, said in a statement.
The team also took note of the patients’ CT scan results and found that overall lung damage dropped from eight points at six weeks to just four points at 12 weeks. Also, fluid damage and inflammation in the lungs caused by SARS-CoV-2 infection showing as white spots and ground glass improved. At six weeks, ground glass patches were seen in 88 percent of patients, but decreased in 56 percent of patients within 12 weeks.
Regarding the ECG results of the patients, the results showed that 58.8 percent of the patients had left ventricular dysfunction at six weeks. Other biological indicators of blood clot formation, inflammation and heart damage rose.
The researchers observed that in the study population, they did not see any serious heart dysfunction associated with the coronavirus in the post-acute phase. However, the observed diastolic dysfunction improved over time.
“The findings of this study show the importance of implementing structured follow-up care for patients with severe COVID-19 infection. Importantly, CT revealed lung damage in this group of patients that was not identified by function tests. Knowing how long-term patients have been affected by coronavirus could allow symptoms and lung damage to be treated much sooner and could have a significant impact on further medical advice and recommendations, “explained Dr. Sahanic.
Pulmonary rehabilitation
Another study from France presented at the same virtual conference showed that severe COVID-19 patients who underwent pulmonary rehabilitation early in their recovery process were linked to improvements in lung capacity, muscle strength, fatigue, balance and certain factors. risk of depression and anxiety. .
“These findings suggest that clinicians should begin rehabilitation as early as possible, that patients should try to spend as little time as possible inactive, and that they should motivate themselves to enroll in the pulmonary rehabilitation program. If their physicians believe it is safe, patients you should start physical therapy exercises while you are still in the lung room of the hospital, “said Yara Al Chikhanie, a doctoral student at the Dieulefit Santé clinic for pulmonary rehabilitation and the Hp2 laboratory at the University of the Alps in Grenoble, France.
