Liam Townsend1,2, Joanne Dowds3, Kate O'Brien3, Grainne Sheill3,3, Adam H Dyer4, Brendan O'Kelly1, John P Hynes5, Aoife Mooney6, Jean Dunne6, Cliona Ni Cheallaigh1,2, Cliona O'Farrelly7,8, Nollaig M Bourke4, Niall Conlon6,9, Ignacio Martin-Loeches10,2, Colm Bergin1,2, Parthiban Nadarajan11, Ciaran Bannan1,2. 1. Department of Infectious Diseases. 2. Department of Clinical Medicine and. 3. Department of Physiotherapy. 4. Department of Medical Gerontology, School of Medicine, Trinity Translational Medicine Institute. 5. Department of Radiology, Mater Misericordiae University Hospital, Dublin, Ireland. 6. Department of Immunology. 7. School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, and. 8. Department of Comparative Immunology and. 9. Department of Immunology, School of Medicine, Trinity College, Dublin, Ireland; and. 10. Department of Intensive Care Medicine, and. 11. Department of Respiratory Medicine, St. James's Hospital, Dublin, Ireland.
Abstract
Rationale: Much is known about the acute infective process of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative virus of the coronavirus disease (COVID-19) pandemic. The marked inflammatory response and coagulopathic state in acute SARS-CoV-2 infection may promote pulmonary fibrosis. However, little is known about the incidence and seriousness of post-COVID-19 pulmonary pathology. Objectives: To describe the respiratory recovery and self-reported health after infection at the time of outpatient attendance. Methods: Infection severity was graded into three groups: 1) not requiring admission, 2) requiring hospital admission, and 3) requiring intensive care unit care. Participants underwent chest radiography and a 6-minute walk test (6MWT). Fatigue and subjective return to health were assessed, and concentrations of CRP (C-reactive protein), IL-6 (interleukin-6), sCD25 (soluble CD25), and D-dimer were measured. The associations between initial illness and abnormal chest X-ray findings, 6MWT distance, and perception of maximal exertion were investigated. Results: A total of 487 patients were offered an outpatient appointment, of whom 153 (31%) attended for assessment at a median of 75 days after diagnosis. A total of 74 (48%) had required hospital admission during acute infection. Persistently abnormal chest X-ray findings were seen in 4%. The median 6MWT distance covered was 460 m. A reduced distance covered was associated with frailty and length of inpatient stay. A total of 95 (62%) patients believed that they had not returned to full health, whereas 47% met the case definition for fatigue. Ongoing ill health and fatigue were associated with an increased perception of exertion. None of the measures of persistent respiratory disease were associated with initial disease severity. Conclusions: This study highlights the rates of objective respiratory disease and subjective respiratory symptoms after COVID-19 and the complex multifactorial nature of post-COVID-19 ill health.
Rationale: Much is known about the acute infective process of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative virus of the coronavirus disease (COVID-19) pandemic. The marked inflammatory response and coagulopathic state in acute SARS-CoV-2 infection may promote pulmonary fibrosis. However, little is known about the incidence and seriousness of post-COVID-19 pulmonary pathology. Objectives: To describe the respiratory recovery and self-reported health after infection at the time of outpatient attendance. Methods:Infection severity was graded into three groups: 1) not requiring admission, 2) requiring hospital admission, and 3) requiring intensive care unit care. Participants underwent chest radiography and a 6-minute walk test (6MWT). Fatigue and subjective return to health were assessed, and concentrations of CRP (C-reactive protein), IL-6 (interleukin-6), sCD25 (soluble CD25), and D-dimer were measured. The associations between initial illness and abnormal chest X-ray findings, 6MWT distance, and perception of maximal exertion were investigated. Results: A total of 487 patients were offered an outpatient appointment, of whom 153 (31%) attended for assessment at a median of 75 days after diagnosis. A total of 74 (48%) had required hospital admission during acute infection. Persistently abnormal chest X-ray findings were seen in 4%. The median 6MWT distance covered was 460 m. A reduced distance covered was associated with frailty and length of inpatient stay. A total of 95 (62%) patients believed that they had not returned to full health, whereas 47% met the case definition for fatigue. Ongoing ill health and fatigue were associated with an increased perception of exertion. None of the measures of persistent respiratory disease were associated with initial disease severity. Conclusions: This study highlights the rates of objective respiratory disease and subjective respiratory symptoms after COVID-19 and the complex multifactorial nature of post-COVID-19 ill health.
Authors: Manuela Funke-Chambour; Pierre-Olivier Bridevaux; Christian F Clarenbach; Paola M Soccal; Laurent P Nicod; Christophe von Garnier Journal: Respiration Date: 2021-06-04 Impact factor: 3.580
Authors: Liam Townsend; Adam H Dyer; Aifric Naughton; Rachel Kiersey; Dean Holden; Mary Gardiner; Joanne Dowds; Kate O'Brien; Ciaran Bannan; Parthiban Nadarajan; Jean Dunne; Ignacio Martin-Loeches; Padraic G Fallon; Colm Bergin; Cliona O'Farrelly; Cliona Ni Cheallaigh; Nollaig M Bourke; Niall Conlon Journal: Front Immunol Date: 2021-05-07 Impact factor: 7.561
Authors: Narges Moghimi; Mario Di Napoli; José Biller; James E Siegler; Rahul Shekhar; Louise D McCullough; Michelle S Harkins; Emily Hong; Danielle A Alaouieh; Gelsomina Mansueto; Afshin A Divani Journal: Curr Neurol Neurosci Rep Date: 2021-06-28 Impact factor: 5.081
Authors: Liam Townsend; Adam H Dyer; Patrick McCluskey; Kate O'Brien; Joanne Dowds; Eamon Laird; Ciaran Bannan; Nollaig M Bourke; Cliona Ní Cheallaigh; Declan G Byrne; Rose Anne Kenny Journal: Nutrients Date: 2021-07-15 Impact factor: 5.717