COVID-19 LUNG SCREENING

What is COVID-19?

COVID-19 is a newly discovered infectious disease caused by a new strain of coronavirus. ‘CO’ stands for corona, ‘VI’ for virus, and ‘D’ for disease. This is an ongoing 2019 pandemic of coronavirus disease (COVID-19) caused by a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

World Health Organisation Explanation on the 2019 Ongoing Coronavirus Pandemic

COVID-19 Vaccine Prevention Strategy

Current evidence from the World Health Organisation shows that the existing COVID-19 vaccines are safe and effective at reducing the risk of catching the disease. The COVID-19 vaccines stimulate a person’s immune system to create antibodies against the virus and allows the body to fight infection before it takes hold and causes severe disease.

Although some individuals fully vaccinated against COVID-19 will develop COVID-19 illness, they are significantly less likely to develop severe illness, hospitalisation and death. A vaccinated person could pass the virus onto a non-vaccinated person without having symptoms but their viral load is such that they are less likely to spread the virus. If you are not vaccinated and contract COVID-19, you are much more likely to spread the virus.

In Ireland, when your age group becomes eligible, you can register online through the HSE portal for COVID-19 vaccination.

Who is at Increased Risk of Developing Severe Disease from COVID-19 Infection?

Older Age Groups (65 Plus)

The risk of developing dangerous symptoms increases with age, with those who are age 65 years and older at the highest risk. Risks are also higher if you have underlying health conditions.

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Pre-Existing Respiratory/Lung Conditions

COVID-19 targets the lungs, so you’re more likely to develop severe symptoms if you have pre-existing lung problems. Your risk of serious symptoms is higher if you have the following conditions:

Smoking or Vaping

Smoking and vaping can harm your lungs and inhibit your immune system, which increases the risk of serious complications with COVID-19.

Heart Disease, Diabetes and Obesity

People with several chronic conditions are more likely to experience dangerous symptoms if infected with COVID-19. These include type 2 diabetes, severe obesity and serious heart diseases.

Cancer Conditions

People who currently have cancer are at higher risk of developing more severe illness from COVID-19. This risk can vary, depending on the type of cancer and the kind of treatment being received.

Weakened Immune System

Conditions that affect your immune system and increase your risk of serious illness from COVID-19 include:

  • Organ transplants
  • Cancer treatments
  • Long-term use of immunosuppressants that treat a range of conditions such as ulcerative colitis, COPD, asthma, rheumatoid arthritis etc.
Chronic Kidney or Liver Disease

If you have chronic kidney or liver disease, you’re at higher risk of becoming seriously ill with COVID-19. 

Are you Concerned that you may have had COVID-19?

The LungCheck service screens to identify COVID-19 sequelae affecting the lungs and/or exercise tolerance. Some individuals may be suffering from a condition called post-COVID-19 syndrome or “long COVID”. Individuals may have been diagnosed with COVID-19, whilst others may suspect they have had COVID-19 but this was never confirmed.

Know the Long-term Symptoms & Effects of ‘long COVID’

Are you still experiencing any of the following symptoms 2 to 3 months after you were confirmed or suspect you contracted the virus?

Fatigue

Shortness of breath or difficulty breathing especially on exertion

Cough

Muscle pain or Headaches

Loss of smell or taste

Joint Pain

Chest Pain

Limited Ability to Exercise

Depression or Anxiety

Impaired Daily Function & Mobility

Progression of Chronic Issues

Memory, concentration or sleep problems also referred to as Cognitive Dysfunction or ‘brain fog’

COVID-19 can lead to inflammation in the lungs due to the infection and the immune system’s reaction to it. The inflammation may improve over time, but in some people, it persists. The long-term impact of COVID-19 is highly variable to each individual and differs depending on several risk factors such as pre-existing conditions and variant of COVID contracted.

The most frequent ‘long COVID’ symptoms/effects reported by patients 6 months after recovery according to patient-led collaborative research reveals:

Reported fatigue, referring to extreme tiredness.

Reported post-exertional malaise (PEM), referring to worsening of symptoms after minimal physical or mental exertion.

Reported cognitive dysfunction, referring to ‘Brain Fog’.

Reported shortness of breath.

Clinical Data Emerging from COVID-19 Clinical Studies

HEAL-COVID (Helping to Alleviate the Longer-term consequences of COVID-19)

The HEAL-COVID national UK study aims to identify therapies and treatments to improve outcomes and to reduce deaths and hospital readmissions among patients who have previously been hospitalised with Covid-19.

Data from the UK Office for National Statistics suggests that 29% of patients who are hospitalised due to Covid-19 are readmitted within 6 months and many are developing new health conditions after being diagnosed with COVID-19.

UKILD (UK Interstitial Lung Disease Long-COVID19 ) Long Covid Consortium

The UK Interstitial Lung Disease Long-COVID19 (UKILD-Long COVID) will investigate the long-term effects of lung inflammation and scarring from COVID-19 and aim to determine if COVID-19 will improve or worsen over time, how long it will last, and the best strategies for developing treatments.

COVID-19 can lead to inflammation in the lungs due to the infection and the immune system’s reaction to it. The inflammation may improve over time, but in some people it persists. In severe cases, the lungs may become scarred. This inflammation and scarring of the lungs is called ‘interstitial lung disease’ often referred to as ILD.

PHOSP-COVID (The Post-hospitalisation COVID-19) a UK National Consortium Study

The PHOSP-COVID was set up as a long-term research study and is the first UK wide study to assess the impact of COVID-19 on patient health and their recovery creating a more comprehensive picture of the impact of COVID-19 on longer term health outcomes across the UK. This study analysed 1,077 patients who were hospitalised with COVID-19. This study aims to identify whether there are longer-term health problems of COVID-19 for those who were hospitalised. The data that is collected during the study will also be used globally, collaborating with consortia in Europe (European Respiratory Society) and Canada (Canadian Thoracic Society), to understand the long terms impacts of COVID-19 on health worldwide. The study is expected to recruit 10,000 patients who were admitted to UK hospital sites with confirmed or suspected COVID-19.

A summary of PHOSP-COVID study findings are as follows:

  • 7 in 10 patients hospitalised with COVID-19 had persistent symptoms 5 months post discharge.
  • Those who experience more persistent symptoms tend to be middle-aged, white, female, with at least 2 ‘co-morbidities’ such as diabetes, lung or heart disease.
  • C-Reactive Protein (CRP) associated with inflammation is elevated in all but the mildest of post-hospital cases.
  • Cognitive impairment also referred to as ‘brain fog’ occurs as a predominant symptom in a subset of patients who tend to be older and male.
NICE (National Institute for Health and Care Excellence) in the UK has developed guidelines for the management of covid-19 in children and adults

The NICE guideline makes recommendations about care in all settings for adults, children and young people with clinically diagnosed or laboratory-confirmed Covid-19. This guideline covers the identification, assessment and management of the long-term effects of COVID-19, often described as ‘long COVID’. It makes recommendations about care in all healthcare settings for adults, children and young people who have new or ongoing symptoms 4 weeks or more after the start of acute COVID-19. It also includes advice on organising services for long COVID.

NICE has produced numerous rapid Covid-19 guidelines in the Magicapp authoring and publication platform to help healthcare workers respond to the ongoing pandemic. This is a global system that promotes evidence sharing from different guideline creators, increasing the speed at which guidance can be developed and the ease with which it can be updated.

The guideline includes new recommendations on therapeutics, and NICE will update the guideline further as new evidence emerges.

COVID-19 Recovery Care

Multidisciplinary Approach & Pulmonary Rehabilitation is Key

The rehabilitation needs of patients are varied and multi-faceted, and post COVID-19 clinics should offer multidisciplinary assessments. Experience from recently established COVID-19 recovery services in Ireland and Britain suggests that significant physical, psychological and cognitive impairments may persist; and that multidisciplinary teams should integrate respiratory, cardiology, rheumatology, radiology, psychology and immunology services into an holistic post-discharge model of follow-up.  The Irish clinical study ‘An integrated multidisciplinary model of COVID-19 recovery care’ study looked at 174 patients who were discharged from Beaumont hospital after Covid-19 related pneumonia. Two-thirds were male, the average age was 66.5 and one-fifth had been on mechanical ventilation. The study demonstrates a post-COVID-19 service structure together with detailed protocols for multidisciplinary follow-up.

The NHS have issued post-COVID-19 patient information pack for regional hospitals to help patient’s recover and manage their symptoms following COVID-19.

Do you have Persistent Long-Lasting Lung Damage Post-COVID-19 Infection?

The LungCheck service screens to identify COVID-19 sequelae affecting the lungs and/or exercise tolerance, both in asymptomatic individuals and individuals who suffered moderate to severe or continue to have long-lasting symptoms after their diagnosis and initial recovery. The latter condition has been called post-COVID-19 syndrome or “long COVID-19”.

Although the treatment needs of COVID-19 survivors are not yet fully appreciated, clinical research from the UK identifies patients at risk of post-discharge complications related to COVID-19 infection. The UK have published a “COVID-19 rapid guideline: managing the long term effects of COVID-19.”

Emerging reports from Wuhan, which is now operating several rehabilitation institutions for COVID-19 survivors, and from Italy indicate that COVID-19 survivors may have developed ground glass opacities or organising pneumonia of the lung leading to interstitial lung disease/pulmonary fibrosis. As it is undetermined if this condition progresses over time, surveillance screening by LungCheck offers a baseline CT scan as a reference point. Referral to a specialist post-COVID-19 clinic may be required.

Do you have reduced exercise tolerance post-COVID-19? Are you unable to resume same fitness levels post-Covid-19?

Most people will make a full recovery from COVID-19 at home, but some may continue to have long-lasting symptoms and unable to regain the same level of fitness before COVID-19. They may need to have an exercise routine set by a LungCheck rehabilitation specialist to help recover.

What Does LungCheck Screening for COVID-19 Lung Infection Involve?

Are you struggling with returning to “normalcy” in everyday life after COVID-19 or worried you had COVID-19 but were never diagnosed and now have symptoms suggestive of long-COVID? The LungCheck service can identify COVID-19 sequelae affecting the lungs and provide a comprehensive medical analysis to help classify, understand and manage these challenges to improve your long-term lung health and wellness.