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Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Magnus Sköld, Karolinska Institutet
- Second opponent: Associate Professor Vegard Skogen, UiT - The Arctic University of Norway
- Third member and chair of the evaluation committee: Professor Theresa M. Olasveengen, University of Oslo
Chair of the Defence
Professor Bjørn Bendz, University of Oslo
Principal Supervisor
Ole Henning Skjønsberg, University of Oslo
Summary
Coronavirus disease of 2019 (COVID-19) is caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Its predilection for the respiratory system with pneumonia and acute respiratory distress syndrome as complications, raised concern of persistent lung injury in survivors.
The aim of this thesis was to assess the pulmonary sequelae in patients hospitalised for COVID-19 in the first wave of the pandemic, by following two cohorts from the research projects “Patient-reported outcomes and lung function after hospital admission for COVID-19” and NOR-Solidarity. Three and twelve months after discharge from hospital, patients answered questionnaires evaluating persistent symptom burden, performed pulmonary function tests, and chest computed tomography, along with blood sampling and biobanking of blood and oropharyngeal swabs.
After three months, persistent dyspnoea was common. Additionally, functional and structural lung abnormalities were prevalent, with impaired diffusion capacity being the most dominant deficit and ground-glass opacities a frequent radiological finding. These changes were more likely to occur in patients who experienced severe respiratory distress during the acute illness, particularly the elderly, those with high viral loads and low antibody responses, and those in need of intensive care. One year later, there was a clear trend towards recovery, with significant improvement in pulmonary function tests, and partial resolution of radiological changes such as ground-glass opacities. However, radiological changes of a fibrotic-like nature persisted, as did the symptom burden with dyspnoea in a notable minority of patients, indicating that recovery is not uniform across all domains.
The persistence of dyspnoea despite physiological and radiological improvement suggests that other factors may play an important role in explaining post-COVID dyspnoea. This warrants further investigation.
Additional information
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