Respiratory sequelae of COVID-19: pulmonary and extrapulmonary origins, and approaches to clinical care and rehabilitation

Sally J Singh, Molly M Baldwin, Enya Daynes, Rachael A Evans, Neil J Greening, R Gisli Jenkins, Nazir I Lone, Hamish McAuley, Puja Mehta, Joseph Newman, Petr Novotny, David J F Smith, Stefan Stanel, Mark Toshner, Christopher E Brightling

Research output: Contribution to journalReview articlepeer-review

Abstract / Description of output

Although the exact prevalence of post-COVID-19 condition (also known as long COVID) is unknown, more than a third of patients with COVID-19 develop symptoms that persist for more than 3 months after SARS-CoV-2 infection. These sequelae are highly heterogeneous in nature and adversely affect multiple biological systems, although breathlessness is a frequently cited symptom. Specific pulmonary sequelae, including pulmonary fibrosis and thromboembolic disease, need careful assessment and might require particular investigations and treatments. COVID-19 outcomes in people with pre-existing respiratory conditions vary according to the nature and severity of the respiratory disease and how well it is controlled. Extrapulmonary complications such as reduced exercise tolerance and frailty might contribute to breathlessness in post-COVID-19 condition. Non-pharmacological therapeutic options, including adapted pulmonary rehabilitation programmes and physiotherapy techniques for breathing management, might help to attenuate breathlessness in people with post-COVID-19 condition. Further research is needed to understand the origins and course of respiratory symptoms and to develop effective therapeutic and rehabilitative strategies.

Original languageEnglish
JournalThe Lancet Respiratory Medicine
Early online date19 May 2023
Publication statusE-pub ahead of print - 19 May 2023


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