Intended for healthcare professionals


Long term respiratory complications of covid-19

BMJ 2020; 370 doi: (Published 03 August 2020) Cite this as: BMJ 2020;370:m3001

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  1. Emily Fraser, respiratory consultant
  1. Oxford University Hospitals NHS Trust, Oxford, UK
  1. emily.fraser{at}

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

It is reported that approximately 30% of people with SARS or Middle East respiratory syndrome had persisting lung abnormalities after their acute illness.2 Two prospective studies followed up healthcare workers with nosocomial SARS infection from hospitals in Hong Kong and Beijing for two and 15 years, respectively, and both studies found that persisting impairments in lung function were common.34 For most patients, however, these deficits were mild and mostly comprised a modest reduction in gas transfer (to around 70-80% of …

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