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Research reveals risk factors for chest problems after COVID-19


The risk of respiratory problems after COVID-19 increases with age and longer hospital stays, according to new research.


An understanding from this research could help doctors to identify which patients most need a follow-up appointment.


The study was driven by experts from the University of Southampton, University Hospital Southampton (UHS) and the NIHR Southampton Biomedical Research Centre (BRC).


Their findings are published in Respiratory Research.


Five-point ‘risk score’


UK patients are advised to have a follow-up appointment and chest X-ray 12 weeks after being hospitalised with COVID-19.


In a previous study, Southampton researchers found persistent chest problems are common at this stage.


They devised a five-point ‘risk score’ that strongly predicted who was most likely to be affected. Risk factors included length of hospital stay, obesity and smoking status.


This latest study aimed to confirm their findings in a new cohort.


COVID-19 data


Researchers analysed information from 182 patients’ follow-up appointments at UHS. Around one third (31%) had ongoing chest problems, such as scarring of the lung.


The data is from the Research Evaluation Alongside Clinical Treatment in COVID-19 study (REACT COVID). REACT COVID was supported by the NIHR Southampton Clinical Research Facility and BRC.


Dr Anna Freeman, REACT COVID co-lead, is also involved in the new research. She explained:


“We collected routine clinical data for patients admitted to UHS with COVID-19 at the start of the pandemic in March 2020, with additional sampling for research if patients were happy to consent.


“It has enabled important research to help identify patients at risk of severe disease. Understanding risk factors for severe disease early in the pandemic was key to improving treatments and reducing critical care demand.


"It could also be helpful in risk stratification for potential future pandemics.”


Increased risk factors


The analysis found that risk of long-term chest problems after COVID-19 increased with age and longer hospital stays.


Those affected were significantly older (64 years vs 55 years) and had stayed in hospital for longer (10.5 days vs 7 days). People with a history of smoking were also at higher risk.


However, there was no association between obesity and likelihood to experience ongoing problems.


Dr Ben Marshall, senior author of the paper, said:


“This study provides clear evidence in support of the ‘risk score’ we have developed.


“It can predict which COVID-19 patients will experience long-term chest problems, saving clinical time. It could potentially be a useful adjunct for future respiratory virus pandemics.”


He added: “The results are a testament to our fantastic respiratory team in Southampton. Their extraordinary efforts throughout the pandemic enabled this research.”


Dr Tim Wallis, first author of the paper, said:


“We were delighted to receive funding from the UHS R&D small grants scheme for this project.


“Further research will aim to understand patients’ experience and expectations of their COVID follow-up clinic journey. This could help inform future pandemic follow-up service design.”

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