Covid 19: Prevention and Early Treatment of Acute Lung Injury (PETAL)- FIRE CORAL

Abstract Early reports suggest that many patients have persistent symptoms lasting months after infection with SARS-CoV2. One US study of 274 symptomatic outpatients with COVID-19 reported that 35% had not returned to their normal state of health 2-3 weeks after initial testing; cough, fatigue, and shortness of breath were the most commonly reported enduring symptoms. (1) An Italian report of 143 patients hospitalized with COVID-19 described that only 13% of patients were symptom-free 60 days after initial symptom onset; in that study, fatigue, dyspnea, joint pain, chest pain, and cough were the most common enduring symptoms. Nearly half reported persistent impairment of health-related quality of life. (2) There is considerable discussion of this phenomenon—coined “long COVID” or “COVID long haulers” in the lay press and, increasingly, in the medical literature. (3) With over 8 million Americans having tested positive for SARS CoV2 by October 2020 and infections on the rise, the public health impact of delayed recovery is enormous. However, the etiologies of these persistent symptoms and impairments remain unclear. The current proposal, FIRE CORAL, will identify 80 patients enrolled in the post-hospital assessment component of the BLUE CORAL study who are able to participate in in-person assessments at participating PETAL Network sites. All FIRE CORAL patients will be scheduled for up to3 return visits during the 12 month after hospital discharge time period for a battery of systematic assessments (detailed in Table A) including pulmonary function (spirometry, lung volume, and diffusing capacity), chest imaging (non-contrast computed tomography – participant’s first visit only), function (6-minute walk testing and short performance physical battery), respiratory questionnaires and biospecimen collection. If participants complete their first study visit prior to 6 months after hospital discharge, they (up to 60 total) will be given the opportunity to return for an additional visit 6-9 months after hospital discharge, scheduled at least 2 months after the prior visit. Up to 80 participants who complete at least one visit within the 3-9 month after hospital discharge time point will complete a 12-month visit.