Evaluating pulmonary sequelae in patients recovering from COVID-19: Short- and mid term complications and correlations with initial disease severity

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) induced coronavirus disease 2019 (COVID-19) pandemic has brought about enormous morbidity, mainly in terms of respiratory function. Although the acute presentations of symptoms have been very well described, the short and mid-term pulmonary sequelae in survivors are poorly characterized. This study aims to evaluate pulmonary sequelae related to the disease COVID-19, focusing on the respiratory impacts that the virus could have on patients during their recovery time. This prospective observational study was conducted at Acharya Vinoba Bhave Rural Hospital from December 2020 to November 2022. A total of 101 discharged COVID-19 patients who fulfilled specific inclusion criteria were chosen. Spirometry was used to estimate lung function, and imaging studies with X-rays and high-resolution computed tomography (HRCT) were performed at six months and one year post discharge. A standardized questionnaire on demography, medical history, and symptomatology was used for data collection. Out of 101 patients, the majority were in the age group of 41-60 years, and 61.4% were males. Common presenting features were cold (89.1%), fever (81.2%), and cough (78.2%). Six-month follow-up revealed that 87.25% of the patients had normal pulmonary function tests, and 26.7% had persistent symptoms, primarily in the form of exertional dyspnea. By the end of one year, 81.37% had normal HRCT findings. In contrast, 7% of the total patients were categorized as having severe disease at presentation and continued to exhibit radiological abnormalities and exertional dyspnea. A correlation was identified between initial disease severity and pulmonary impairment, highlighting the need for long-term follow-up in this population. This study highlights the importance of long-term monitoring of COVID-19 survivors, particularly concerning pulmonary sequelae and their relationship with initial disease severity. Continued research is necessary to understand how COVID-19 may impact a patient's lung health and well-being for an extended period, guiding future clinical management and care approaches for managing patients.