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Glover, N.A.* ; Ivanova, O.* ; Sathar, F.* ; Riess, F.* ; Shambhu, R.R.* ; Mekota, A.M.* ; Zurba, L.* ; Menezes, C.* ; Alexandra van Blydenstein, S.* ; Kalla, I.* ; Hoelscher, M. ; Saathoff, E.* ; Charalambous, S.* ; Rachow, A.

Lung outcomes and related risk factors in patients after SARS-CoV-2 infection: A hospitalised single-centre cohort from Johannesburg, South Africa.

EClinicalMedicine 71:102588 (2024)
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Background: Sequelae post-SARS-CoV-2 infection, including lung and functional impairment, pose a significant challenge post-recovery. We explored the burden and risk factors for post-COVID-19 sequelae in an African population with prevalent comorbidities including tuberculosis (TB) and HIV. Methods: We conducted an observational cohort study on hospitalised adults with confirmed SARS-CoV-2 infection from 20 March to 06 October 2021 at Chris Hani Baragwanath Academic Hospital, South Africa. We collected data on comorbidities, and COVID-19 severity using the World Health Organization (WHO) clinical progression scale. Prospectively, we followed up all participants within 40-days post-discharge to assess body mass index (BMI), COVID-19 symptoms and quality of life using St George's Respiratory Questionnaire (SGRQ), 6-min walking-test (6MWT), and spirometry. A subsequent in-depth visit assessed plethysmography, diffusing capacity for the lung for carbon monoxide (DLCO), and high-resolution chest-CT. Findings: We followed up 111 participants, where 65.8% were female, median age 50.5 years, and predominantly black-African (92.8%). Relevant comorbidities included TB disease (18.9%) and HIV infection (36%). SGRQ total scores were elevated in 78.9%, median 6MWT distance was reduced at 300 m (IQR 210–400), and nearly half (49.5%) exhibited spirometry findings below the lower limit of normal (LLN). In-depth pulmonary assessment for 61 participants revealed abnormalities in total lung capacity (31.6% <80% predicted), DLCO (53.4% <80% predicted), and chest-CT (86.7% abnormal). Significant risk factors for individual abnormal outcomes, adjusted for age and sex, were TB disease, HIV with CD4 <200 cells/mm3, BMI <18.5 kg/m2 and >35 kg/m2, and initial COVID-19 severity. Interpretation: This study demonstrates substantial lung and functional morbidity within the first weeks post-COVID-19, particularly in individuals with pre-existing comorbidities including TB, HIV, and low or high BMI. Chest-CT and DLCO show best early potential at reflecting COVID-19-related pathologies. Funding: The Bavarian State Ministry of Science and Arts.
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Publication type Article: Journal article
Document type Scientific Article
Keywords Africa ; Covid-19 ; Hiv ; Long-covid ; Post-covid-19 ; Tuberculosis; Hiv
Language english
Publication Year 2024
HGF-reported in Year 2024
ISSN (print) / ISBN 2589-5370
e-ISSN 2589-5370
Journal EClinicalMedicine
Quellenangaben Volume: 71, Issue: , Pages: , Article Number: 102588 Supplement: ,
Publisher Springer
Publishing Place Radarweg 29, 1043 Nx Amsterdam, Netherlands
Reviewing status Peer reviewed
Institute(s) Research Unit Global Health (UGH)
POF-Topic(s) 30205 - Bioengineering and Digital Health
Research field(s) Enabling and Novel Technologies
PSP Element(s) G-540001-003
Grants Bavarian State Ministry of Science and Arts
DOI 10.1016/j.eclinm.2024.102588
WOS ID 001230363800001
Scopus ID 85189946337
PubMed ID 38623400
Erfassungsdatum 2024-05-22
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