Pulmonary Dysfunction in Patients Recovered from COVID-19 Pneumonia: A 6-Month Follow-up Study

Abstract

Objectives: This study investigates the clinical features and pulmonary functions of COVID-19 pneumonia survivors at 3 or 6 months after diagnosis in the Heilongjiang Province, China.Methods: Forty-six patients with COVID-19 pneumonia diagnosed since February 2020 were enrolled in this study for follow-up in July 2020. These patients were categorized into three groups: Group A (n=24) and Group B (n=11) who were diagnosed with moderate or severe pneumonia and followed up at three months after diagnosis; Group C (n=11) who were diagnosed with severe pneumonia and followed up at six months after diagnosis. Data on pulmonary function, arterial blood gas analysis, chest CT, blood test, antibody test, and health-related quality of life during hospitalization and at the follow-up visits were collected and analyzed. Results: Abnormal PO2 (A-a) was more prevalent in severe cases (Group B and C) than in moderate cases (Group A). Pulmonary dysfunction was common in this cohort. Abnormal CT scores of severe cases (Group B and C) were significantly higher than that of moderate cases (Group A). During the follow-up, lung abnormalities gradually resolved in the first 3 months (Group A and B), however, further resolution was not significant from 3 months to 6 months (Group B and C). Conclusion: Although pulmonary interstitial changes due to COVID-19 pneumonia gradually reverse over time, pulmonary dysfunction is common and appears to persist at least up to 6 months in patients recovered from COVID-19 pneumonia.

What might COVID-19 patients experience after recovery? A comprehensive review

“…Thirty-six studies from 15 different countries reported respiratory complications among COVID-19 survivors. [ 11–14 , 16 , 19 , 20 , 22 , 24 , 26–28 , 31–33 , 36–38 , 40–42 , 44 , 45 , 47–49 , 51 , 54 , 55 , 58 , 59 , 67 , 69 , 72 , 74 , 75 ] Around 1778 patients suffered from respiratory complications after their recovery, which ranged from breathlessness to changes in pulmonary function. Out of this number, almost 581 patients had required oxygen supply and 237 had invasive or non-invasive ventilation during their infection.…”

Prevalence of Functional Limitation in COVID-19 Recovered Patients Using the Post COVID-19 Functional Status Scale

“…Persisting symptoms with subsequent progression to poor functional status have been reported in a substantial proportion of COVID-19 survivors. 14,15 Pulmonary function impairment 16 , mental health problems, 17 and reduced quality of life 18 to a various extent have been reported in COVID-19 patients. These factors could have a long term impact on physical, mental, social and cognitive health and well being of COVID-19 infected patients, causing a decline in functional status.…”

What might COVID-19 Patients Experience after Recovery? A Systematic Review

“…Abnormalities in diffusion capacity for carbon monoxide (DLCO) and TLC were detected among COVID-19 survivors. Thus, they demonstrated the abnormal parenchymal diffusion that persisted in some recovered patients for up to 6 months post infection 44 . In addition, reduction in lung function based on FEV1 measurements may prove the restrictive lung disease that persisted in COVID-19 survivors 35 .…”

“…In a British study , 60% of the survivors had reported some persistent abnormalities in the lung parenchyma through lung magnetic resonance imaging (MRI) at 2-3 months post discharge 35 . Furthermore, abnormal FEV1 (<80%) or FEV1/FVC < 70% , MEF 50, MEF 25, MMEF 75/25 were presented in 52.17%, 72.73% ,and 45.45% of cases who had previously moderate/sever COVID-19 44 .…”

“…This study also revealed a correlation between the presence of differential metabolites such as homotyrosine, lactoylglutathione, indolelactate in the recovered patients and the residual lesions in the lung 51 . Other studies reported complications including abnormal diffusion / pleural diffusion, pulmonary embolism, and pneumonia 18,31,40,44,52 .…”