Clinical observations of elderly patients with dyspnea in the late post-COVID-19 period

Dyspnea in elderly patients is one of the most common symptoms in clinical practice; its interpretation requires a deep diagnostic search and exclusion of different pathological conditions and diseases. Many patients who had suffered a new coronavirus infection, for a long time after being discharged from the hospital or completing an outpatient course of therapy, continued to notice a number of clinical manifestations, which later became known as Post-COVID-19 syndrome. Patients who had a severe course of COVID-19 with lung tissue damage deserve a special attention. As clinical observations demonstrate that even several years after new coronavirus infection, pathological changes in lungs can persist and sometimes progress, which is accompanied by respiratory symptoms, the most common of which is dyspnea. Taking into account the diversity of pathogenic mechanisms of SARS-CoV-2, pathological changes in the lung tissue may have a different mechanism and nature (conditionally fibrotic and non-fibrotic), the development of which is influenced by a combination of exogenous and endogenous factors of the patient. The article presents clinical observations of patients with dyspnea in the late post-COVID-19 period with different mechanisms of lung tissue damage, who suffered from severe COVID-19. The article analyzes a set of potential risk factors for the persistence and further progression of post-COVID-19 pulmonary changes in the presented patients, and compares data with the most relevant scientific and clinical information of the world scientific sources. Further accumulation of information on the current problem may help to develop diagnostic and therapeutic algorithms for the management the post-COVID-19 pulmonary injuries, which will improve the quality and duration of life in such patients.

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