Liam Townsend on COVID-19 Severity and Persistent Outcomes

The initial severity of COVID-19 does not appear to be associated with ongoing health outcomes, according to the results of a recent study.

The researchers conducted an analysis of data from 153 patients who attended an outpatient appointment at a median of 75 days after initial diagnosis with COVID-19. Overall, they found that no measures of persistent respiratory disease were associated with the patients’ initial disease severity.

Consultant360 reached out to study author Liam Townsend, Research Fellow in the Department of Clinical Medicine, Trinity Translational Medicine Institute, Trinity College, Dublin, Ireland for more information.

Consultant360: How did you decide to focus your study on long-term outcomes among patients post-COVID-19 and the effects of disease severity on these outcomes?

Liam Townsend: There has been a large amount of work conducted to help our understanding of the clinical and pathological features of acute COVID-19. However, the aftermath and recovery of convalescent patients remains an area that is under-studied. We set out to address some of these knowledge deficits by evaluating persistent ill-health and respiratory disease following infection.

C360: Overall, you found that initial severity of infection did not appear to be related to ongoing health issues or to abnormal chest imaging. Were these results surprising to you? If so, why?

LT: Our initial hypothesis was that patients with severe initial infection would be more likely to have ongoing symptoms and abnormal imaging. However, we found a very low rate (4%) of persistent abnormal imaging in the study population, which suggests that significant lung fibrosis is uncommon. Subjective symptoms, including ongoing feeling of ill-health, fatigue, and breathlessness, are unrelated to initial infection severity and there are no clear predictors of their development.

C360: How do your findings contribute to the existing understanding of COVID-19 and its varied lingering effects on patients?

LT: Our findings demonstrate the burden of symptoms that patients continue to experience in the aftermath of COVID-19, and the relative absence of diagnostic tests or robust biomarkers to assess these. It also highlights the importance of following all patients diagnosed with COVID-19, irrespective of severity of initial infection, to monitor for persistent ill-health.

C360: Based upon your results, what should future studies focus on to continue building our understanding of this disease?

LT: The symptoms and clinical characteristics of post-COVID ill-health are now being described. However, there have been no pathological or mechanistic pathways demonstrated that lead to the development of these symptoms. Future studies are needed to address this knowledge gap. Adequate effective management will only be achieved by understanding the underlying pathology.


Townsend L, Dowds J, O’Brien K, et al. Persistent poor health post-COVID-19 is not associated with respiratory complications or initial disease severity. Published online January 8, 2021. Ann Am Thorac Soc. doi: 10.1513/AnnalsATS.202009-1175OC.