Pulmonary manifestations of long COVID in Johannesburg, South Africa.

Background: There are few studies of long coronavirus disease (COVID) in low- and middle-income countries. Objectives: This study investigated long-term pulmonary manifestations of long COVID among adults in Johannesburg, South Africa. Method: This was a respiratory sub-study of a larger long COVID investigation. Cases with self-reported long COVID symptoms were recruited into four cohorts: prior asymptomatic infection, mild to moderate infection, hospitalised for severe infection and vaccinated prior to infection. Cases with respiratory comorbidity and/or well-characterised exposure to certain conditions (e.g. cigarette smoking) were excluded. Demographics, clinical features, spirometry, six-minute walk test (6MWT) and high-resolution computerised tomographic (HRCT) scan of the chest were recorded. Results: Of the 171 patients interviewed from the initial study, 36 with appropriate inclusion criteria were recruited a median of 2.1 years following their acute COVID-19 illness. Accordingly, the incidence of long COVID was 21.1% (36/171 patients) for the group as a whole and 5.9% (3/51), 25.0% (14/56), 37.8% (17/45) and 10.5% (2/19) for cohorts 1-4, respectively ( Conclusion: This study documented respiratory abnormalities in patients as long as 2 years after prior SARS-CoV-2 infection, especially among those with severe prior infection. Contribution: This was among the first studies comprehensively documenting pulmonary abnormalities in patients with long COVID in South Africa.