Clinico-radiological recovery following severe COVID-19 pneumonia
By A Creamer, S Alaee, H Iftikhar, F Ahmed, H Steer, C Sharp
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Background and Problem
The recovery course following COVID-19 pneumonia remains poorly understood. Analysis of routine clinical and imaging follow up of patients admitted with COVID-19 pneumonia undertaken in accordance with British Thoracic Society (BTS) guidance offers an op-portunity to improve our understanding of the recov-ery course following acute infection.
Methods
A local follow up service utilising available resources including telephone clinics, ambulatory care units and respiratory clinics was developed as an initial response to the pandemic. The pathway was taken from BTS guidelines and adapted to meet local resources as well as specifically addressing the increased thromboem-bolic risk recognised.
All patients requiring ICU or respiratory HDU level care at Gloucestershire Hospitals NHS Foundation Trust with COVID-19 pneumonia were offered telephone re-view and interval chest radiograph (CXR) at 6 and 12 respectively. All chest radiographs were reported by a consultant radiologist.
Results
N=73 patients requiring follow up clinic review were discharged within the 5-week period of analy-sis (74% male, mean age 57.6 years, range 22-84). N=41 (56.1%) had been admitted to ITU, with the remainder admitted to HDU.
Following discharge, N=6 (8.2%) were re-admitted within 30 days (median time to first re-admission 19.1 days). N=2 (3.5%) patients were diagnosed with pulmonary emboli following the index admis-sion.
Follow up calls occurred with N=57 patients, at me-dian 9.6 weeks post discharge (range 6-12 weeks). Patient reported persistence of symptoms at time of review is summarised in table 1.
Results of 12-week CXR are in table 2 (N=49).