Affecting 10-30% of COVID patients with mild infections and 50-70% of those with severe infections, long COVID is defined by the World Health Organization as symptoms persisting for at least two months in individuals with confirmed or probable SARS-CoV-2 infection more than three months prior.
There is an article that is highly recommended for those interested in the post-COVID-19 condition and dyspnoea. Nugent and Berdine provide a comprehensive overview of the post-acute sequelae of SARS-CoV-2, commonly known as long COVID.
The authors discuss the variability in long COVID prevalence based on infection severity, comorbidities, healthcare access, and treatment outcomes. They emphasize the importance of initial evaluations, including a comprehensive history and physical examination, with further investigations as necessary. The article highlights the identification of dysfunctional breathing patterns in long COVID patients and notes that pre-existing depression, anxiety, female gender, and older age are associated with post-COVID breathlessness. The authors explore the presence of residual lung disease in some patients and severe dyspnea without evident pulmonary disease in others. They discuss the role of dysfunctional breathing patterns, such as hyperventilation syndrome, periodic deep sighing, and thoracoabdominal asynchrony, and the use of cardiopulmonary exercise testing (CPET) for diagnosis. The article also discuss the benefits of physical rehabilitation in improving functional exercise capacity, reducing dyspnea, and enhancing quality of life in post-COVID patients, despite no significant changes in spirometry results. The authors call for future research to better understand respiratory control, pulmonary involvement, and respiratory muscle dysfunction in post-COVID patients.
Recommended Reading: Dyspnea and Long COVID Patients Nugent K, Berdine G.. Am J Med Sci. 2024 Oct;368(4):399-404. DOI: 10.1016/j.amjms.2024.07.024
