Long-term sequelae are highly prevalent one year after hospitalization for severe COVID-19

Abstract

Many coronavirus disease 2019 (Covid-19) survivors show symptoms months after acute illness. The aim of this work is to describe the clinical evolution of Covid-19, one year after discharge. We performed a prospective cohort study on 238 patients previously hospitalized for Covid-19 pneumonia in 2020 who already underwent clinical follow-up 4 months post-Covid-19. 200 consented to participate to a 12-months clinical assessment, including: pulmonary function tests with diffusing lung capacity for carbon monoxide (DLCO); post-traumatic stress (PTS) symptoms evaluation by the Impact of Event Scale (IES); motor function evaluation (by Short Physical Performance Battery and 2 min walking test); chest Computed Tomography (CT). After 366 [363–369] days, 79 patients (39.5%) reported at least one symptom. A DLCO < 80% was observed in 96 patients (49.0%). Severe DLCO impairment (< 60%) was reported in 20 patients (10.2%), related to extent of CT scan abnormalities. Some degree of motor impairment was observed in 25.8% of subjects. 37/200 patients (18.5%) showed moderate-to-severe PTS symptoms. In the time elapsed from 4 to 12 months after hospital discharge, motor function improves, while respiratory function does not, being accompanied by evidence of lung structural damage. Symptoms remain highly prevalent one year after acute illness.

Risk factors for impaired pulmonary diffusion function in convalescent COVID-19 patients: A systematic review and meta-analysis

“…A total of 4112 patients were included, including 2127 males and 1985 females, of whom 2414 (58.7%) patients completed the carbon monoxide diffusing test. The mean/median age of the subjects of the 11 studies 25 , 26 , 28 , 29 , 30 , 31 , 32 , 34 , 35 , 37 , 38 on DLCO was over 50 years.…”

“…In most studies, the diagnostic criterion for the impairment of DLCO was DLCO < 80% of predicted. 17 , 25 , 26 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 Except for the study performed by Ayad Mohammed Salem, 41 the diagnostic criterion was DLCO < 75% of predicted. There were 100% follow-up rates in 14 studies, 17 , 26 , 27 , 28 , 29 , 30 , 33 , 34 , 35 , 36 , 37 , 38 , 40 , 41 90% in two studies 31 , 32 , 51% in one study 25 and 87.3% in one study 39 Seventeen studies 17 , 25 , 26 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 have reported 14.3% to 67% COVID-19 survivors with impaired diffusing capacity for carbon monoxide.…”

“…All of the 18 included studies are observational studies, of which 16 are cohort studies, 17 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 one is a prospective, cross-sectional study 40 and one is a cross-sectional case-control study. 41 The included studies were published between 2020 and 2021 and were conducted in seven countries including China, Germany, Italy, Spain, Chile, Norway and Saudi Arabia.…”

“…17 papers 17 , 25 , 26 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 reported risk factors associated with DLCO impairment and 12 studies were included in the meta-analysis. 17 , 25 , 26 , 28 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 One mentioned risk factor for diffusion capacity for nitric oxide (DLNO) impairment. 27 Due to insufficient data and uncertain definitions of DLNO and Restrictive Pattern, this review focuses on a meta-analysis of risk factors for impaired DLCO.…”

Multi-organ impairment and Long COVID: a 1-year prospective, longitudinal cohort study

“…Several studies confirm persistence of symptoms in individuals with Long COVID up to 1 year [20][21][22] . We now add that 3 in 5 people with Long COVID have impairment in at least one organ, and 1 in 4 have impairment in two or more organs, in some cases without symptoms.…”