Department of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, New Delhi.
Department of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of Delhi.
Monaldi Arch Chest Dis. 2021 Mar 8;91(3). doi: 10.4081/monaldi.2021.1682.
In the present COVID-19 pandemic situation, there is a gradual increase in number of patients with post-COVID-19 sequalae. The present study is a retrospective analysis of these post-COVID-19 patients presenting to one of the units of Viswanathan Chest Hospital, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi in the period from 17 June 2020 to 22 October 2020. We analysed the demographic profile, history, functional assessment and all investigations of this study cohort. Out of the 2,165 patients provided consultation, there were 35 patients of post-COVID-19, which were included in the present study. These patients had a mean duration of 47 days from discharge to first visit to our hospital. Pre-existing respiratory comorbidity was present in 63%. History of hospitalisation was present in 52%. Fatigue (65%) was the most common symptom followed by breathlessness (60%), cough (45.71%) and chest pain (28.57%). Three patients had significant desaturation on 6-minute walk test and one patient had type 2 respiratory failure on presentation. Chest X-ray was abnormal in 34.28% (n=12). On CT thorax (n=17) the most common finding was diffuse reticulations (52.94%) followed by diffuse ground glass opacities (GGOs) (35.29%). One patient each were newly diagnosed as pulmonary tuberculosis and tubercular unilateral hilar lymphadenopathy. Conclusively, post-COVID-19 patients may have remnant symptoms like fatigue, breathlessness and cough. Also, patients with pre-existing respiratory diseases are more symptomatic and even may suffer from deterioration in the clinical course. Further we need to be alert of alternate diagnosis or infections like tuberculosis (TB) in these patients, especially in TB endemic countries like India. Simultaneously, the use of immunosuppressant drugs like steroids for COVID-19 management, predisposes to TB. A proper evaluation with holistic and standardised management plan is the need of the hour for post-COVID-19 patients, until its time course, evolution and manifestations are unravelled.
在当前的 COVID-19 大流行情况下，患有 COVID-19 后遗症的患者人数逐渐增加。本研究对 2020 年 6 月 17 日至 2020 年 10 月 22 日期间在德里大学 Viswanathan 胸科医院 Vallabhbhai Patel 胸科研究所的一个单位就诊的这些 COVID-19 后患者进行了回顾性分析。我们分析了该研究队列的人口统计学特征、病史、功能评估和所有检查。在提供咨询的 2165 名患者中，有 35 名 COVID-19 后患者，包括在本研究中。这些患者从出院到首次就诊我院的平均时间为 47 天。63%的患者有预先存在的呼吸系统合并症。52%的患者有住院史。疲劳（65%）是最常见的症状，其次是呼吸困难（60%）、咳嗽（45.71%）和胸痛（28.57%）。3 名患者在 6 分钟步行试验中出现明显的低氧血症，1 名患者在就诊时出现 2 型呼吸衰竭。34.28%（n=12）的胸部 X 线检查异常。17 例胸部 CT 最常见的发现是弥漫性网状影（52.94%），其次是弥漫性磨玻璃影（GGOs）（35.29%）。各有 1 例患者新诊断为肺结核和结核单侧肺门淋巴结肿大。综上所述，COVID-19 后患者可能会残留疲劳、呼吸困难和咳嗽等症状。此外，有预先存在的呼吸系统疾病的患者症状更明显，甚至可能在病程中恶化。此外，我们需要警惕这些患者中可能出现其他诊断或感染，如结核病（TB），特别是在印度等结核病流行国家。同时，COVID-19 管理中使用免疫抑制剂药物如类固醇会导致结核病。对 COVID-19 后患者进行全面和标准化的管理计划评估是当前的需要，直到其时间过程、演变和表现得到揭示。
