What the study found
Among non-hospitalised adults referred to a post-COVID respiratory clinic, shortness of breath was common and was often accompanied by dysregulated breathing, reduced physical performance, and frailty. The authors report that dysregulated breathing, deconditioning, and psychological distress were key factors linked with symptom burden.
Why the authors say this matters
The authors conclude that a multidisciplinary approach should be considered to optimise recovery. They suggest this because symptoms were associated with breathing pattern changes, physical deconditioning, and psychological distress rather than with common spirometry and chest CT abnormalities.
What the researchers tested
The study used a cross-sectional analysis of 210 non-hospitalised adults with persistent respiratory symptoms after COVID-19 who were referred to a post-COVID respiratory clinic between December 2020 and July 2024. Researchers assessed demographics, symptoms, lung function, chest CT, and patient-reported outcome measures, including the Medical Research Council (MRC) dyspnoea score, Nijmegen Questionnaire, Hospital Anxiety and Depression Scale, Chalder Fatigue Scale, Short Physical Performance Battery, and Fried Frailty Index, and they used multivariate logistic regression to examine associations.
What worked and what didn't
95% of participants reported shortness of breath, 54% had clinically significant breathlessness, 68% had Nijmegen Questionnaire scores consistent with dysregulated breathing, 32% had low Short Physical Performance Battery scores, and 77% were classed as frail or pre-frail. Higher body mass index and depression were associated with clinically significant breathlessness, while dysregulated breathing was associated with female sex, current or former smoking, fatigue, anxiety, and depression; low physical performance was associated with female sex, current smoking, depression, clinically significant breathlessness, dysregulated breathing, and greater deprivation. Spirometry and chest CT abnormalities were not common, and nearly half of those employed before infection had not returned to previous hours.
What to keep in mind
This was a cross-sectional study, so it describes associations rather than cause and effect. The sample came from adults referred to one post-COVID respiratory clinic and included only those who consented to research, so the findings may not apply to all people after COVID-19.
Key points
- In 210 non-hospitalised adults with persistent post-COVID respiratory symptoms, 95% reported shortness of breath.
- 68% had a Nijmegen Questionnaire score consistent with dysregulated breathing.
- 32% had low physical performance, and 77% were classed as frail or pre-frail.
- Higher body mass index and depression were associated with clinically significant breathlessness.
- Spirometry and chest CT abnormalities were not common in this group.
Disclosure
- Research title:
- Persistent post-COVID respiratory symptoms linked to dysregulated breathing
- Authors:
- Malik Hamrouni, A Gupta, Sophie Middleton, Sabrina Prosper, Theresa Harvey-Dunstan, Joanne Porte, Tricia M. McKeever, Ian Hall, Charlotte E. Bolton
- Institutions:
- Nottingham Biomedical Research Centre, Nottingham Biomedical Research Centre, Nottingham Biomedical Research Centre, Nottingham Biomedical Research Centre, Nottingham Biomedical Research Centre, Nottingham Biomedical Research Centre, Nottingham Biomedical Research Centre, Nottingham Biomedical Research Centre, Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham University Hospitals NHS Trust, Nottingham University Hospitals NHS Trust, Nottingham University Hospitals NHS Trust, Nottingham University Hospitals NHS Trust, University of Nottingham, University of Nottingham, University of Nottingham, University of Nottingham, University of Nottingham, University of Nottingham, University of Nottingham
- Publication date:
- 2026-03-05
- OpenAlex record:
- View
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