Publication:

Respiratory health challenges among post-COVID-19 individuals: a community-oriented clinical study of pulmonary sequelae and functional decline

Background The long-term respiratory impact of COVID-19 has emerged as a major healthcare concern, with many recovered individuals continuing to experience dyspnoea, reduced pulmonary function, and exercise intolerance. Persistent impairment in diffusion capacity (DLCO) and reduced respiratory endurance have been widely reported among post-COVID patients. This study aimed to evaluate pulmonary sequelae and functional impairment among post-COVID individuals in the Jaipur region through community-based clinical assessment.

Methods A total of 200 post-COVID adults attending NIMS University were evaluated using standardized pre- and post-assessment procedures. Assessments included spirometry, pulse oximetry, DLCO testing (where available), radiographic evaluation, 6-minute walk test (6MWT), modified Medical Research Council (mMRC) dyspnoea scale, and inspiratory muscle strength testing. Data were analysed using descriptive statistics, paired t-tests, Pearson correlation, and multivariate logistic regression.

Results Significant improvement was observed in pulmonary parameters, with mean FVC increasing from 76.4% to 82.1% predicted (p<0.001), FEV1 from 72.9% to 79.2% (p<0.001), and DLCO from 68.3% to 74.5% (p<0.001). However, 28.5% of participants continued to exhibit pulmonary impairment. Functional capacity also improved, with mean 6MWT distance reaching 401.3 m (p<0.001), although 22% remained below predicted levels. Age, smoking, severe acute COVID-19, biomass exposure, and comorbidities were identified as significant predictors of persistent respiratory sequelae.

Conclusions Despite partial recovery, a substantial proportion of post-COVID individuals continue to experience respiratory and functional limitations. The findings highlight the need for routine long-COVID screening, structured pulmonary rehabilitation, and targeted management strategies for high-risk populations.