BMJ Editorial: Long term respiratory complications of covid-19
https://www.bmj.com/content/370/bmj.m3001
"Substantial population morbidity is likely"
The extent and severity of the long term respiratory complications of covid-19 infection remain to be seen, but emerging data indicate that many patients experience persistent respiratory symptoms months after their initial illness.1
Recently published guidance by the NHS lays out the likely aftercare needs of patients recovering from covid-19 and identifies potential respiratory problems including chronic cough, fibrotic lung disease, bronchiectasis, and pulmonary vascular disease.
The evidence for these possible sequelae is largely derived from acute manifestations of covid-19, along with extrapolations from the 2003 outbreak of severe acute respiratory syndrome (SARS) and data on acute respiratory distress syndrome (ARDS).2
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To summarise, persistent respiratory complications following covid-19 may cause substantial population morbidity, and optimal management remains unclear.
Prospective studies are under way to evaluate these complications further and to identify people at greatest risk.
Meanwhile, a pragmatic approach to primary care management might include first line investigations such chest radiography and oxygen saturation measurements, with referral to secondary care where lung pathology needs investigation.
Integrated support from a broader primary care team should be considered for patients with more complex symptoms, including those with disproportionate functional impairment.