❦ ‘The occurrences of respiratory disorders among patients who survived for 30 days after the COVID-19 diagnosis continued to rise consistently, including asthma, bronchiectasis, COPD, ILD, PVD, and lung cancer.
With the severity of the acute phase of COVID-19, the risk of all respiratory diseases increases progressively.
Besides, during the 24-months follow-up, we observed an increasing trend in the risks of asthma and bronchiectasis over time, which indicates that long-term monitoring and meticulous follow-up of these patients is essential.
These findings contribute to a more complete understanding of the impact of COVID-19 on the respiratory system and highlight the importance of prevention and early intervention of these respiratory sequelae of COVID-19.
In this study, several key findings have been further identified.
Firstly, our research demonstrates a significant association between COVID-19 and an increased long-term risk of developing various respiratory diseases.
Secondly, we found that the risk of respiratory disease increases with severity in patients with COVID-19, indicating that it is necessary to pay attention to respiratory COVID-19 sequelae in patients, especially those hospitalized during the acute stage of infection.
This is consistent with the findings of Lam et al., who found that the risk of some respiratory diseases (including chronic pulmonary disease, acute respiratory distress syndrome and ILD) increased with the severity of COVID-19.
Notably, however, our study found that asthma and COPD remained evident even in the non-hospitalized population.
This emphasizes that even in cases of mild COVID-19, the healthcare system should remain vigilant.
Thirdly, we investigated differences in risk across time periods, as well as the long-term effects of COVID-19 on respiratory disease.
During the 2-years follow-up period, the risks of COPD, ILD, PVD and lung cancer decreased, while risks of asthma and bronchiectasis increased.
Fourthly, our study showed a significant increase of the long-term risk of developing asthma, COPD, ILD, and lung cancer diseases among individuals who suffered SARS-CoV-2 reinfection.
This finding emphasizes the importance of preventing reinfection of COVID-19 in order to protect public health and reduce the potential burden of SARS-CoV-2 reinfection.
Interestingly, vaccination appears to have a potentially worsening effect on asthma morbidity compared with other outcomes.
This observation aligns with some previous studies that have suggested a possible induction of asthma onset or exacerbation by COVID-19 vaccination.
It suggests that more care may be necessary for patients with asthma on taking the COVID vaccines.
The underlying mechanisms associated with COVID and respiratory outcomes are not fully understood, but several hypotheses have been proposed.
First, SARS-CoV-2 can persist in tissues (including the respiratory tract), as well as the circulating system for an extended period of time after the initial infection.
This prolonged presence of the virus could directly contribute to long-term damage of the respiratory tissues, consequently leading to the development of various respiratory diseases.
Second, it has been observed that SARS-CoV-2 infection can lead to prolonged immunological dysfunctions, including highly activated innate immune cells, a deficiency in naive T and B cells, and increased expression of interferons and other pro-inflammatory cytokines.
These immune system abnormalities are closely associated with common chronic respiratory diseases – asthma, bronchiectasis, COPD, as well as the development of lung cancer.
Next, SARS-CoV-2 itself has been shown to drive cross-reactive antibody responses, and a range of autoantibodies were found in patients with COVID-19.
In conclusion, our research adds to the existing knowledge regarding the effects of COVID-19 on the respiratory system.
Specifically, it shows that the risk of respiratory illness increases with the severity of infection and reinfection.
Our findings emphasize the importance of providing extended care and attention to patients previously infected with SARS-CoV-2.’
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📖 (17 Feb 2024 ~ The Lancet: eClinical Medicine) Long-term risks of respiratory diseases in patients infected with SARS-CoV-2: a longitudinal, population-based cohort study ➤
© 2024 The Lancet: eClinical Medicine.
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