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BackgroundThe symptoms, radiography, biochemistry and healthcare utilisation of patients with COVID-19 following discharge from hospital have not been well described.MethodsRetrospective analysis of 401 adult patients attending a clinic following an index hospital admission or emergency department attendance with COVID-19. Regression models were used to assess the association between characteristics and persistent abnormal chest radiographs or breathlessness.Results75.1% of patients were symptomatic at a median of 53 days post discharge and 72 days after symptom onset and chest radiographs were abnormal in 47.4%. Symptoms and radiographic abnormalities were similar in PCR-positive and PCR-negative patients. Severity of COVID-19 was significantly associated with persistent radiographic abnormalities and breathlessness. 18.5% of patients had unscheduled healthcare visits in the 30 days post discharge.ConclusionsPatients with COVID-19 experience persistent symptoms and abnormal blood biomarkers with a gradual resolution of radiological abnormalities over time. These findings can inform patients and clinicians about expected recovery times and plan services for follow-up of patients with COVID-19.

Introduction Management of malignant pleural disease has advanced over the past decade with the role of a pleural specialist service becoming increasingly essential in efforts to optimise patient care. The use of indwelling pleural catheters (IPC) has changed the arena in which malignant pleural effusions (MPE) can be managed, allowing more patient autonomy and less use of hospital resources. The LENT scoring system, validated in 2014, is often used to guide decision making in patients with MPE. Current ATS recommendations suggest IPCs are not suitable in individuals with a ‘very short survival’ prognosis however this determination is variable and is an example of where the LENT scoring system may be involved. Methods Retrospective analysis was carried out on patients who underwent IPC insertion at our institution between 2016 and 2019. All patients were seen in the specialist pleural service and underwent subsequent intervention. Data collected included primary cancer diagnosis, date of first pleural aspiration, LENT score, observed complications, IPC removal date if applicable and date of death to calculate survival time. Results 58 patients underwent successful IPC insertion of which 5 were for non-malignant disease (2/5 refractory heart failure, 3/5 advanced liver cirrhosis). The remaining 53 patients all had a confirmed pathological diagnosis of malignant pleural effusion. At the time of submission, 8 patients remained alive and were excluded from analysis leaving a remaining 45 cases. Using LENT assessment 13/45 classed as high risk, 31/45 as moderate and 1/45 as low. The observed average survival time in high risk patients was 122 days and median 93 days. This was notably higher than the anticipated 44 days predicted median survival time noted in the literature. Conclusion Our data suggests that high risk patients according to LENT assessment were more likely to live longer following IPC intervention and aftercare. This suggests that use of prognostic assessment tools may be ineffective in this sub-group and should be employed with caution. The improved patient outcomes reinforce the benefit of a dynamic responsive pleural service. They may also reflect upon the increased recognition of tumour heterogeneity alongside the recent advent of novel molecular based therapies.

Intro: Guidelines advise screening patients for latent TB infection (LTBI) prior to initiation of biologic therapy. We examined the impact of interferon gamma release assay (IGRA) availability on rates of adequate screening and treatment for LTBI prior to biologic therapy in a low TB incidence setting. Method: We analysed clinic letters, laboratory and pharmacy data to assess LTBI screening for patients starting biologics at a UK district general hospital between 2009-14. We used logistic regression to identify predictors of LTBI treatment. Results: 450 patients initiated biologics 2009-14: 116 before, and 334 after, IGRA availability (Jan 2010). 100/334 (30%) were IGRA tested. Adequate screening, defined as any immunological test and clinical review, increased with IGRA availability but remained low (105/334 vs 14/116; p Conclusion: LTBI screening in patients starting biologics improved after IGRA availability, but 69% were inadequately screened. Historically a negative IGRA has not influenced the decision to treat, but improved data on the negative predictive value of IGRAs may reduce treatment rates. In our limited sample, this did not adversely affect outcomes.