Study of the Respiratory Sequelae in Covid-19 Patients from Tertiary Care Centre

Abstract

Background: Coronavirus Disease 2019 (COVID-19), caused by SARS- CoV-2, has led to widespread morbidity, with emerging evidence of  long-term pulmonary sequelae in recovered patients. While much focus has been placed on acute management, systematic evaluation of post-recovery respiratory function remains limited, especially in the Indian population. This study aimed to evaluate the clinical, function-al, and radiological respiratory sequelae in patients recovering from varying severities of COVID-19 over a 12-month period.
Materials and Methods: A prospective cohort study was conducted at Northern Railway Central Hospital (NRCH), New Delhi, including 150 adult patients recovered from laboratory-confirmed COVID-19. Participants were categorised equally into mild, moderate, and severe groups based on initial illness severity. Exclusion criteria included pre-existing pulmonary or cardiac diseases. Clinical symptoms, pul-monary function tests (PFTs), the six-minute walk test (6MWT), and radiological findings (chest X-ray and CT) were evaluated at 3, 6 and
12 months post-discharge.
Results: Persistent dyspnoea and cough were more prevalent in the severe group and gradually improved over time. The severe group demonstrated significantly reduced oxygen saturation (mean SpO2: 92% at 3 months), lower 6MWT distances (mean: 490.4 m), and high- er Borg dyspnoea scores (mean: 6.9) compared to other groups (p <0.001). Abnormal PFTs were most frequent in severe cases (82% at 3 months), with restrictive defects predominating. RALE scores and follow-up CT findings indicated sustained parenchymal abnormalities,
including ground-glass opacities and interstitial thickening, especially in severe cases.
Conclusion: The majority of COVID-19 patients experienced clinical and functional improvement within the first 6 months post-recovery. However, those with initially severe disease had persistent respiratory impairments and radiological abnormalities even at 12 months. These findings underscore the need for structured long-term follow-up and pulmonary rehabilitation in patients recovering from severe COVID-19.