BackgroundThe coronavirus infectious disease (COVID-19) pandemic is an ongoing global health care challenge. Up to one third of hospitalised patients develop severe pulmonary complications and ARDS. Pulmonary outcomes following COVID-19 are unknown.MethodsThe Swiss COVID-19 lung study is a multicentre prospective cohort investigating pulmonary sequela of COVID-19. We report on initial follow-up 4 months after mild/moderate or severe/critical COVID-19 according to the WHO severity classification.Results113 COVID-19 survivors were included (mild/moderate 47, severe/critical 66). We confirmed several comorbidities as risk factors for severe/critical disease. Severe/critical disease was associated with impaired pulmonary function, i.e. diffusing capacity (DLCO) %-predicted, reduced 6-MWD, and exercise-induced oxygen desaturation. After adjustment for potential confounding by age, sex, and BMI, patients after severe/critical COVID-19 had a 20.9 (95% CI 12.4–29.4, p=0.01) lower DLCO %-predicted at follow up. DLCO %-predicted was the strongest independent factor associated with previous severe/critical disease when age, sex, BMI, 6MWD, and minimal SpO2 at exercise, were included in the multivariable model (adjusted odds ratio [OR] per 10%-predicted 0.59 [95% CI 0. 37–0.87], p=0.01). Mosaic hypoattenuation on chest computed tomography at follow-up was significantly associated with previous severe/critical COVID-19 including adjustment for age and sex (adjusted OR 11.7 [95%CI 1.7–239), p=0.03).ConclusionsFour months after SARS CoV-2 infection, severe/critical COVID-19 was associated with significant functional and radiological abnormalities, potentially due to small airway and lung parenchymal disease. A systematic follow-up for survivors needs to be evaluated to optimise care for patients recovering from COVID-19.

Quality of life in DMD is not correlated with physical impairment nor the need for noninvasive positive-pressure ventilation. The surprisingly high quality of life experienced by these severely disabled patients should be taken into consideration when therapeutic decisions are made.

BACKGROUND: Duchenne muscular dystrophy (DMD) leads to progressive impairment of muscle function, respiratory failure and premature death. Longitudinal data on the course of physical disability and respiratory function are sparse. OBJECTIVES: To prospectively assess physical impairment and disability, respiratory function and survival in DMD patients over several years in order to describe the course of the disease with current care. METHODS: In 43 patients with DMD, aged 5-35 years, yearly assessments of physical disability by the Duchenne muscular dystrophy physical Impairment and Dependence on care (DID) score ranging from 9 (no disability) to 80 (complete dependence), and forced vital capacity (FVC) were obtained over a mean +/-SD time interval of 5.4 +/-2.1 years. RESULTS: DID scores were correlated with age according to a hyperbolic function (f=85.3*age/(10.05+age), R=0.62, P<0.0001). FVC declined exponentially with age (f=139.1*exp(-0.08*age)), R=0.52, P<0.0001. Mean +/-SD age at which patients lost their ambulation was 9.4 +/-2.4 years and they became dependent on an electro-wheelchair at 14.6 +/-4.0 years. The age at beginning of assisted ventilation was 19.8 +/-3.9 years, Three patients deceased during the observation period. The estimated probability of survival to age 30 years was 85%, median survival was 35 years. CONCLUSIONS: Our detailed observations of the progression of physical disability, dependence on care and respiratory impairment in DMD patients from childhood to adult life is valuable for predicting the clinical course with current medical care. Compared to historical data, survival has considerably improved. Objectives: To prospectively assess physical impairment and disability, respiratory function and survival in DMD patients over several years in order to describe the course of the disease with current care. Methods:In 43 patients with DMD, aged 5-35 years, yearly assessments of physical disability by the Duchenne muscular dystrophy physical Impairment and Dependence on care (DID) score ranging from 9 (no disability) to 80 (complete dependence), and forced vital capacity (FVC) were obtained over a mean ±SD time interval of 5.4 ±2.1 years.

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