Dyspnea in Post-Acute COVID-19: A Multi-Parametric Cardiopulmonary Evaluation

Area of Science:

• Pulmonology
• Cardiology
• Infectious Diseases

Background:

• Post-acute COVID-19 frequently involves persistent dyspnea, with unclear underlying pathophysiology.
• Understanding factors predicting and associated with dyspnea is crucial for patient management.

Purpose of the Study:

• To evaluate the prevalence of dyspnea during follow-up after COVID-19 hospitalization.
• To identify factors at admission and follow-up associated with persistent dyspnea.

Main Methods:

• A cohort of 225 patients hospitalized for moderate to severe COVID-19 pneumonia underwent clinical assessment, laboratory tests, echocardiography, the six-minute walking test (6MWT), and pulmonary function tests five months post-discharge.
• Statistical analysis identified independent predictors and associated factors for dyspnea.

Main Results:

• Fifty-one patients reported persistent dyspnea.
• Predictors of dyspnea at admission included C-reactive protein, longer hospitalization duration, and higher body mass index.
• At follow-up, absolute SpO2 drop during 6MWT, right ventricular global longitudinal strain, and RV global longitudinal strain/systolic pulmonary artery pressure ratio were associated with dyspnea.

Conclusions:

• Dyspnea is a common sequela in patients hospitalized for COVID-19 pneumonia.
• While admission factors like CRP, BMI, and hospitalization length predict persistent dyspnea, follow-up findings like desaturation and RV dysfunction are associated with its presence.