Research suggests initially severe covid-19 may not be associated with ongoing symptoms

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Research suggests that the initial severity of covid-19 may not be associated with later respiratory complications.

Almost a year after the first cases of covid-19, it can still be difficult -- or even impossible -- to predict which patients will go on to develop lasting symptoms based on the degree of severity of their infection. Now, a new study from researchers in Ireland suggests that the initial severity of covid-19 may not be systematically associated with later respiratory complications.

Can different forms of covid-19 have an impact on potential long-term symptoms, particularly when it comes to lung function? That's what researchers in Europe set out to investigate, basing their research on 153 patients who were followed in an outpatient clinic for a median of 75 days after their covid-19 diagnoses. The aim was to determine whether later respiratory problems, fatigue and ill health were associated with the disease's initial severity.

For the study, the researchers evaluated the severity of patients' initial infection on three levels: not requiring hospital admission; requiring hospital admission, and requiring ICU care. Almost half of the sample -- or 74 patients -- required hospitalization due to an acute infection. Patients were subject to various tests, including chest X-rays and blood tests, as well as endurance tests and questionnaires, to identify any lasting symptoms.

Published in the journal, Annals of the American Thoracic Society, the study suggests that covid-19 does not cause significant fibrosis. Lung scarring was seen on CT scans of only 4% of study participants, following the x-ray detection of earlier abnormalities in a larger group.

"We were surprised by our findings. We expected a greater number of abnormal chest x-rays. We also expected the measures of ongoing ill-health and abnormal findings to be related to severity of initial infection, which was not the case," explains Dr. Liam Townsend, of the Department of Infectious Diseases, St. James's Hospital in Dublin.

Whatever the initial degree of severity, more than six in 10 patients (62%) said that they did not feel that they had returned to full health over the course of the study, while 47% were classed as having fatigue. "These findings have implications for clinical care, in that they demonstrate the importance of following up all patients who were diagnosed with covid-19, irrespective of severity of initial infection. It is not possible to predict who will have ongoing symptoms," Dr. Townsend concludes.