Many patients with severe asthma have poor control of their disease. The number of exacerbations is the variable with the greatest effect on control of asthma. Knowledge of the disease and adherence to treatment are associated with better control.

Introduction LUNG INJURY COVID-19 (clinicaltrials.gov NCT 21/399-E) is a registry-based prospective observational cohort study to evaluate long-term outcomes and recovery 12 months after SARS-CoV-2 infection according to severity. Results 305 COVID-19 survivors were included (moderate: 162, severe: 143). 12 months after SARS-CoV-2 infection, there was resolution of respiratory symptoms (37.9% in severe versus 27.3% in moderate pneumonia; p = 0.089). Exertional dyspnea was present (20% in severe vs 18.4% in moderate, p = 0.810). Abnormalities in chest radiology imaging were detected in severe COVID-19 infection versus moderate infection (29% versus 8.8%; p <0.001). Pulmonary function testing (forced spirometry or diffusion) performed at 12 months of mean follow-up according to protocol detected anomalies in 31.4% of patients with severe COVID-19 courses and in 27.7% of moderate patients. Risk factors associated with diffusion impairment at 12 months were age (OR: 1.05, 95% CI: 1.01-1.10, p = 0.008), FEV1% predicted at follow-up (OR: 0.96, 95% CI: 0.93-0.99, p = 0.017) and dyspnea score at follow-up (OR: 3.16, 95% CI: 1.43-6.97, p = 0.004). CT scans performed at 12 months of mean follow-up showed evidence of fibrosis in almost half of patients with severe COVID-19 courses, who underwent CT according to protocol. Conclusions At 12 months from infection onset, most patients refer to symptoms, particularly muscle weakness and dyspnea, and almost one third of patients with severe COVID-19 pneumonia had impaired pulmonary diffusion and abnormalities in chest radiology imaging. These results emphasize the importance of a systematic follow-up after severe COVID-19, with appropriate management of pulmonary sequelae.

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