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Scientific article
Open access
English

Respiratory recovery trajectories after severe-to-critical COVID-19: a 1-year prospective multicentre study

Published inEuropean respiratory journal, vol. 61, no. 4, 2201532
First online date2023-04-01
Abstract

Background: Survivors of severe-to-critical coronavirus disease 2019 (COVID-19) may have functional impairment, radiological sequelae and persistent symptoms requiring prolonged follow-up. This pragmatic study aimed to describe their clinical follow-up and determine their respiratory recovery trajectories, and the factors that could influence them and their health-related quality of life.

Methods: Adults hospitalised for severe-to-critical COVID-19 were evaluated at 3 months and up to 12 months post-hospital discharge in this prospective, multicentre, cohort study.

Results: Among 485 enrolled participants, 293 (60%) were reassessed at 6 months and 163 (35%) at 12 months; 89 (51%) and 47 (27%) of the 173 participants initially managed with standard oxygen were reassessed at 6 and 12 months, respectively. At 3 months, 34%, 70% and 56% of the participants had a restrictive lung defect, impaired diffusing capacity of the lung for carbon monoxide (DLCO) and significant radiological sequelae, respectively. During extended follow-up, both DLCO and forced vital capacity percentage predicted increased by means of +4 points at 6 months and +6 points at 12 months. Sex, body mass index, chronic respiratory disease, immunosuppression, pneumonia extent or corticosteroid use during acute COVID-19 and prolonged invasive mechanical ventilation (IMV) were associated with DLCO at 3 months, but not its trajectory thereafter. Among 475 (98%) patients with at least one chest computed tomography scan during follow-up, 196 (41%) had significant sequelae on their last images.

Conclusions: Although pulmonary function and radiological abnormalities improved up to 1 year post-acute COVID-19, high percentages of severe-to-critical disease survivors, including a notable proportion of those managed with standard oxygen, had significant lung sequelae and residual symptoms justifying prolonged follow-up.

eng
Keywords
  • Adult
  • Humans
  • COVID-19
  • SARS-CoV-2
  • Cohort Studies
  • Prospective Studies
  • Quality of Life
  • Lung / diagnostic imaging
  • Oxygen / therapeutic use
Citation (ISO format)
SCHLEMMER, Frédéric et al. Respiratory recovery trajectories after severe-to-critical COVID-19: a 1-year prospective multicentre study. In: European respiratory journal, 2023, vol. 61, n° 4, p. 2201532. doi: 10.1183/13993003.01532-2022
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Identifiers
ISSN of the journal0903-1936
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Technical informations

Creation10/20/2023 11:51:11 AM
First validation11/09/2023 3:02:45 PM
Update time11/09/2023 3:02:45 PM
Status update11/09/2023 3:02:45 PM
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