PhD Scientific Days 2023

Clinical Medicine V.

Post-COVID interstitial lung disease in symptomatic patients after COVID-19 disease

Text of the abstract

Introduction: COVID-19 is often associated with long-lasting pulmonary symptoms. Data are scarce about interstitial lung disease (ILD) in patients following COVID-19 hospitalization with persistent symptoms.
Methods: We retrospectively reviewed all cases sent to pulmonary post-COVID evaluation due to persistent symptoms between February 2021 and February 2022 (N=318). All patients with suspected ILD (N=44) were reviewed at the multidisciplinary discussion. Patient characteristics, symptoms, time since hospitalization, detailed lung function measurements and 6-minute walk test (6MWT) were evaluated.
Results: The post-COVID ILD suspected group included more men (68.2 vs. 31.8%) with significantly older age compared to the control group (64.0±12.3 vs. 51.3± 14.9 years). Most patient needed hospital care for COVID-19 pneumonia (68.6% of all patients and 84.1% of ILD suspected group) and average time since hospitalization was 2.4±2.3 months. Persisting symptoms included fatigue (34%), dyspnoea (25.2%), cough (22.6%), and sleep disorders (insomnia 13.2%; sleepiness 8.2%). Post-COVID ILD presented more often with new symptoms of cough and sleepiness. Functional impairment, especially decreased walking distance and desaturation during 6-minute walk test (6MWT) were detected in the ILD-suspected group. Respiratory function test in the post-COVID ILD group showed slight restrictive ventilatory pattern (FVC: 76.7±18.1%, FEV1: 83.5±19.1%, TLC: 85.6±28.1%) and 6MWT did confirm post-exercise desaturation in 41% of patients. LDCT changes were mainly ground glass opacities (GGO) and/or reticular abnormalities in most cases affecting <10% of the lungs.
Conclusion: Our data indicate that suspected post-COVID ILD is affecting 13.8% of symptomatic patients. Slight functional impairment and mainly low extent GGO/reticulation were seen, while long-term lung structural changes need further evaluation.
Funding: This study was partly supported by 202-1.1.6-JÖVŐ-2021-00010 and Eötvös Loránd Research Network SA-45/2021. Dorottya Fesu was supported by the New National Excellence Program of The Ministry for Culture and Innovation from the source of the National Research, Development, and Innovation Fund ÚNKP-22-2-I. Lorinc Polivka is a participant of the MD-PhD excellence program and received scholarship from Semmelweis University EFOP-3.6.3-VEKOP-16-2017-00009).