In the spring of 2020, hospitals had to deal with a massive influx of patients with a severe form of Covid-19, most of them suffering from pulmonary complications. More than a year later, the heads of the pulmonology department continue to monitor some of them. It must be said that patients have had persistent symptoms weeks after being infected.
This is what shows a study carried out over the past summer and recently released in its full version. It was carried out by the teams of
Toulouse University Hospital out of 72 patients who developed a severe form of inflammatory lung disease, most of whom were hospitalized in intensive care or intensive care during the first wave. “Four months later, although most had returned home, 61% were symptomatic, with the main symptom being respiratory discomfort for 44% of patients, but also fatigue for 31%”, explains Elisa Noël-Savina, pulmonologist at Toulouse University Hospital and co-author of the study. Whether they went into intensive care or were hospitalized in a traditional ward, patients have identical symptoms regardless of the degree of initial severity. “This shows that it is multi-factorial”, continues Elisa Noël-Savina.
For those who are still hesitant to get vaccinated: 4 months after severe pneumonia # COVID19 61% of patients still have symptoms, 39% have abnormalities on respiratory tests and 41% have radiological abnormalities. @CHUdeToulouse #Vaccinate https://t.co/V0noUa9smh pic.twitter.com/7gDuCJVVsD
– Julien Mazieres (@JulienMazieres) July 8, 2021
Respiratory discomfort with multiple origins, therefore, whether it is the after-effects of inflammation on the parenchyma of the lung, its functional tissue, or even deconditioning after going to intensive care. There is also the hyperventilation syndrome that many patients with long Covid suffer from. If everything is normal during the exams, as well as the CT scan, they have trouble breathing normally. “On the first wave, the Covid was a kind of big trauma, with post-traumatic stress that could manifest itself in this hyperventilation syndrome. It would be interesting to see what happens after the following waves, there was certainly less anxiety about what was going to happen afterwards for the patients since we had already experienced the first wave, ”explains the pulmonologist.
Improvement at one year
The treatments also changed between March 2020 and last fall or spring. The prescription of corticosteroids thus made it possible to limit the sequelae. Still, all those who had severe forms during the first wave did not have a normal CT scan four months later. In 23.6% of cases, their lungs no longer fully inflated when breathing or they suffered from respiratory muscle dysfunction in more than 18% of cases.
“On the scans, there were a lot of sequelae of inflammatory lung disease that persisted. But at one year, things are improving. It is not irreversible, which is important in motivating patients for breathing exercises that allow muscle rehabilitation. Some still need oxygen at four months, but we manage to wean them, ”continues the pulmonologist. The cleaning of the parenchyma of the lung is done naturally, but it can take time.