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

• Published in: EClinicalMedicine 2024-05, Vol.71, p.102588-102588, Article 102588
• Main Authors: Glover, Nicole Audrey, Ivanova, Olena, Sathar, Farzana, Riess, Friedrich, Shambhu, Rekha Rao, Mekota, Anna-Maria, Zurba, Lindsay, Menezes, Colin, Alexandra van Blydenstein, Sarah, Kalla, Ismail, Hoelscher, Michael, Saathoff, Elmar, Charalambous, Salome, Rachow, Andrea
• Format: Article
• Language: English
• Subjects: Africa; COVID-19; HIV; Long-COVID; Post-COVID-19; Tuberculosis
• ISSN: 2589-5370; 2589-5370
• DOI: 10.1016/j.eclinm.2024.102588

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. 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. 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%