S55 Persistent changes to the nasal ciliated epithelium following SARS-CoV2 infection: a longitudinal cohort analysis from FOLLOW-COVID

BackgroundSARS-CoV2 binds to the respiratory epithelium. Little is known about the recovery and regeneration of the epithelium following COVID-19. Poor recovery could leave individuals at risk of secondary bacterial infection and persistent symptoms.The aim of this study was to assess epithelial recovery following SARS-CoV2 infection across a range of acute illness severities.Methods41 people were recruited at 3–12 months post PCR confirmed SARS-CoV2 infection. The respiratory epithelium was sampled by brushing the nasal inferior turbinate. Ciliary function was assessed by high-speed video microscopy and ultrastructure was assessed by electron microscopy. A subset of patients had repeat nasal brushing 3–5 months following their first visit. Demographics, severity of infection and longitudinal symptoms were recorded for comparison. Results were compared to healthy controls and historical controls recruited prior to the pandemic.ResultsPost-COVID epithelium was friable and most samples contained detached single cells and blood. Epithelial disruption score was 3.0 ±0.6 compared to 2.4 ±0.6 for controls (p