SESSION TITLE: Long COVID: It Can Take Your Breath Away
SESSION TYPE: Original Investigations
PRESENTED ON: 10/16/2022 10:30 am - 11:30 am
PURPOSE: As the novel coronavirus SARS-CoV-2 swept the globe causing COVID-19 infection, a syndrome now known as “long COVID” has been well described in 10-30% of those who have experienced COVID-19. This study hoped to characterize changes in anatomical structure and physiology that may explain the ongoing dyspnea experienced by some individuals affected by the COVID-19 pandemic.
METHODS: Patients with a history of symptomatic COVID-19 confirmed by positive PCR or antibody testing, between the age of 18-65, without pre-existing significant cardiopulmonary disease, and currently experiencing ongoing exertional or respiratory symptoms at least 3 months after onset of initial COVID symptoms were enrolled into this study. Each participant underwent standardized testing for underlying cardiopulmonary pathology by performance of a high-resolution chest CT, transthoracic echocardiography, electrocardiogram, full pulmonary function testing with lung volumes and diffusing capacity, impulse oscillometry, and a six minute walk test.
RESULTS: To date, 63 patients have enrolled in the study with ongoing completion of study procedures. Of the current patients enrolled, 29 have had a high resolution chest CT completed; 16 or 55% had radiographic evidence of pulmonary pathology. Most common were a nodular pattern (38%), mosaic attenuation (34%), residual ground glass opacities (28%), septal thickening (14%). Thirty-six participants performed the six minute walk test with an average walk distance of 1338.9 feet ± 520.4 feet with no participants desaturating below 90%. Pulmonary function testing has been completed in 36 participants with normal mean values. Impulse oscillometry testing performed on 30 individuals revealed mixed results with resistance at 5 Hz (R5) showing no substantive change to bronchodilator with a -14% ± 5%, however the area of reactance showed a potentially significant bronchodilator response with bronchodilator change of -43% ± 41%.
CONCLUSIONS: In this interim analysis, we evaluated the radiographic and physiologic changes seen in a group of patients at least three months after symptomatic infection with COVID-19. There were radiographic changes in 50% of patients with a reticulonodular pattern as the most often reported finding. However, this finding did not correlate with PFT or exercise findings in the cohort; few showed significant PFT changes and the 6MWT did not show desaturations or limitation in walking distance. Pulmonary function testing and impulse oscillometry showed no statistically substantive physiologic derangements that might explain the ongoing symptoms of the group evaluated.
CLINICAL IMPLICATIONS: Other than radiographic findings, there were no unified findings that could shed further light on the effects of COVID-19 that would predispose an individual to ongoing symptoms.
DISCLOSURES: No relevant relationships by Brian Agan
no disclosure on file for Timothy Burgess;
no disclosure on file for Anuradha Ganesan;
No relevant relationships by Stephen Goertzen
No relevant relationships by Travis Harrell
no disclosure on file for Nikhil Huprikar;
No relevant relationships by David Lindholm
No relevant relationships by Katrin Mende
Speaker/Speaker's Bureau relationship with Janssen Please note: $1001 - $5000 by Michael Morris, value=Honoraria
Speaker/Speaker's Bureau relationship with GSK Please note: $1001 - $5000 by Michael Morris, value=Honoraria
Removed 03/29/2022 by Michael Morris
no disclosure on file for Simon Pollett;
no disclosure on file for Julia Rozman;
No relevant relationships by Mark Simons
No relevant relationships by David Tribble
No relevant relationships by Robert Walter