Evaluation of patients hospitalized in our hospital's clinics due to COVİD-19 in terms of long-term effects of COVID-19 one year after diagnosis

Purpose: In addition to mortality, COVID-19 disease causes many post-COVID morbidities. Respiratory symptoms (physiological effects) and radiological sequelae lesions are observed in the vast majority of patients recovering from COVID-19 disease in the short term. However, the long-term effects are still unknown. Our aim with this study is to evaluate hospitalized COVID-19 cases clinically, physiologically and radiologically one year after discharge. Method: Patients hospitalized in our clinics due to COVID-19 disease were called for control one year later by phone. Patients with known lung disease prior to COVID-19 were excluded from the study. 82 patients with written consent were included in the study. The symptoms and physical examination findings of the patients were recorded. Radiological, laboratory, echocardiographic and spirometry tests were performed. Cases with at least 10% or more exposure on tomography images, we classified it into three group; organized pneumonia pattern dominant group, fibrosis-like changes were grouped as parenchymal band dominant group. Results: The mean age of 82 cases was 54.3±12.15 (28-86). 43 (52.4%) were male and 39 (47.6%) were female. your cases. 7 (8.5%) were smokers, 17 (20.7%) of them were ex-smoker; 58 (70.7%) of them had never used cigarette. 69(%84.15) patients had at least one symptom such as shortness of breath, cough, weakness, and forgetfulness after one year. 13 (15.85%) had no symptoms. Most common symptoms were; dyspnea(%46.34) and forgetfulness(%40.24). The mean mMRC score of the cases was 1.5±1.06. When the thorax computed tomography findings of the cases were examined one year later; It was observed that 29.3%(24) of them still had radiological involvement. Thoracic tomography of 58 patients(%70.7) was observed as normal. On thorax CT: organized pneumonia pattern in 1 (1.2%) case; Fibrosis-like changes were observed in 9 cases (11%); Parenchymal bands were observed in 14 (17.1%) cases. The mean age of the cases affected on thorax CT; higher than the mean age of the normal patients. 6 minutes walking test distance was higher on unaffected radiological group. sPAP was 30 mmHg and above in 9 cases and TLCO was ≤60% in 6 cases. Prolonged symptoms were detected less frequently in patients who did not need oxygen during their hospitalization (p<0.025). In the analyzes performed in terms of the parameters and the presence of prolonged symptoms in the first-year controls, it was observed that the percentage of FEV1 was significantly lower in the symptomatic group (p<0.016). On the other hand, there was significant decrease in walking distance of the group with persistent symptoms in 6MWT (p<0.009). The MMRC score was also significantly higher in the group with persistent symptoms (p<0.001). Radiological sequelae development was more common in smokers (p<0.026). Patients with low lymphocyte levels at hospitalization had more radiological sequeale lesions (p=0.014). We observed CRP (p=0.018) and D-Dimer (p=0.002) levels at hospitalization were higher than patients without radiological involvement (p<0.05). It was observed that the 6MWT value of the group with fibrosis-like changes in the tomography was lower than the other groups (p=0.012), and the mMRC score was statistically significantly higher (p<0.023). Discussion and Conclusion: 46.34% of 82 patients who did not have any known lung disease before COVID-19 had dyspnea in the first year after COVID-19. There was still more than 10% radiological involvement in 29.3% of the cases. mMRC scores were 1.5 on average. The sPAB was 30 mmHg and above in 9 of the cases. TLCO was 60% or less in 6 of the cases. COVID-19 is a disease that affects many systems, mostly the respiratory system, and health problems associated with COVID-19 seem to continue for many years. Keywords: COVID-19, persistent symptoms, fibrosis