An Exploratory Retrospective Study on the Clinical Progression of Predominantly Hispanic Patients with COVID 19 in a Pulmonary Clinic in the Rio Grande Valley

Rationale We observed a large number of convalescent patients recovering from COVID-19 who were referred to the pulmonary office with persistent respiratory symptoms including cough and dyspnea on exertion. A significant portion of those patients had diabetes, hypertension, and obesity as comorbidities. Objective To explore and determine which clinical variables could be associated with persistent respiratory symptoms, abnormal lung physiology, or radiographic abnormalities in patients recovering from COVID-19. Methods Using an electronic medical record, we query the pulmonary office system for patients evaluated for COVID-19 pneumonia between March and November 2020. A total of 150 patients were identified. 52% of the sample were males and 99% were Hispanics. 69% of patients (N=138) were previously hospitalized and the remaining ones were treated as ambulatory patients by their primary providers. Results From the sample, 68% (N=130) had a body mass index (BMI) greater than 30, 55% (N=150) presented hypertension and 41% (N=150) had diabetes. We observed that 68% (N=142) experienced persistent dyspnea on exertion (DOE) after 30 days of COVID-19 diagnosis. 71% (N=88) of the patients who experienced persistent DOE after 30 days had a BMI greater than 30. The 84% (N=113) showed abnormal findings on lung imaging (chest computed tomography or chest xrays). From a subgroup of 53 patients who underwent pulmonary function tests in the office, 47% showed a restrictive ventilatory defect and 68% presented a decreased diffusion capacity. Conclusions Based on the empirical evidence reported on this abstract, further research should be directed to investigate if the clinical variables delineated above (diabetes, obesity, hypertension and previous hospitalization) may increase the likelihood of persistent dyspnea, abnormal lung imaging or abnormal pulmonary function tests in convalescent patients recovering from COVID-19. At the same time, we would recommend clinicians to consider evaluating their convalescent patients with persistent respiratory symptoms for abnormal pulmonary physiology or post inflammatory radiographic changes specially if the patients presented the clinical variables delineated in this abstract.