Long-Term Cardiopulmonary Sequelae in Severe COVID-19 Survivors

Abstract

Background: Severe coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 has resulted in high morbidity and mortality worldwide. In addition to the acute disease, an increasing number of patients, particularly those who had severe disease, present with ongoing symptoms and dysfunction of organs, a syndrome known as long COVID. The cardiopulmonary system appears to be highly susceptible to long-term consequences. Objective: To assess the chronic cardiopulmonary complications in survivors of severe COVID-19. Methodology: This was a cross-sectional observational study of 235 adult patients hospitalized with severe COVID-19 and followed up at least three months after discharge. Baseline demographics, clinical information, residual symptoms, pulmonary function tests (PFTs), high-resolution computed tomography (HRCT) chest abnormalities, and cardiovascular evaluations were collected. Results: The mean age of participants was 58.4 ± 12.6 years, with 62.1% being male. At follow-up, 58.7% reported dyspnea, 51.9% fatigue, and 47.2% exercise intolerance. PFTs revealed reduced DLCO in 51.5% and obstructive or restrictive defects in a significant subset. HRCT abnormalities persisted in over 80% of patients, with ground-glass opacities (45.1%) and fibrotic changes (34.9%) being the most common. Cardiovascular abnormalities were found in 28.9% as abnormal ECGs, 13.6% as left ventricular dysfunction, and 50% as myocardial fibrosis on cardiac MRI. 23.8% and 8.1% had elevated NT-proBNP and hs-Troponin I, respectively. Conclusion: A high percentage of patients recovering from serious COVID-19 are left with persistent cardiopulmonary abnormalities, such as compromised lung function, residual radiological alterations, and cardiac impairment. These results highlight the importance of thorough long-term follow-up and multidisciplinary management for COVID-19 survivors, with a particular emphasis on cardiopulmonary health.