Pulmonary function and Quality of Life in a prospective cohort of (non-) hospitalized COVID-19 pneumonia survivors up to six months

Abstract

Objectives A decrease of both diffusion capacity (DLCO) and Quality of Life (QoL) was reported after discharge in hospitalized COVID-19 pneumonia survivors. We studied three and 6 month outcomes in hospitalized and non-hospitalized patients. Methods COVID-19 pneumonia survivors ( n = 317) were categorized into non-hospitalized “moderate” cases ( n = 59), hospitalized “severe” cases ( n = 180) and ICU-admitted “critical” cases ( n = 39). We studied DLCO and QoL (Short Form SF-36 health survey) 3 and 6 months after discharge. Data were analyzed using (repeated measures) ANOVA, Kruskal-Wallis or Chi-square test ( p < .05). Results At 3 months DLCO was decreased in 44% of moderate-, 56% of severe- and 82% of critical cases ( p < .003). Mean DLCO in critical cases (64±14%) was lower compared to severe (76 ± 17%) and moderate (81±15%) cases ( p < .001). A total of 159/278 patients had a decreased DLCO (<80%), of whom the DLCO improved after 6 months in 45% (71/159). However the DLCO did not normalize in the majority (89%) of the cases (63 ± 10% vs 68±10%; p < .001). At 3 months, compared to critical cases, moderate cases scored lower on SF-36 domain “general health” ( p < .05); both moderate and severe cases scored lower on the domain of “health change” ( p < .05). At 6 months, there were no differences in SF-36 between the subgroups. Compared to 3 months, in all groups “physical functioning” improved; in contrast all groups scored significantly lower on “non-physical” SF-36 domains. Conclusion Three months after COVID-19 pneumonia, DLCO was still decreased in the more severely affected patients, with an incomplete recovery after 6 months. At 3 months QoL was impaired. At 6 months, while “physical functioning” improved, a decrease in “non-physical” QoL was observed but did not differ between the moderate and severely affected patients.

Pulmonary function 3–6 months after acute COVID-19: A systematic review and multicentre cohort study

“…Results of all included studies can be found in Table S1 . All studies included a population with a mean or median age between 47 and 66 years and most studies had an equal distribution of males and females.The majority of the studies were conducted in Europe (n = 26) [ [3] , [4] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] ],49,51,56,60,62,65,66,67,69,70,74,76,77,79,80,81,83,84], six were conducted in North America [ [59] , [60] , [61] , [62] , [63] , [64] ], four in South America [ [65] , [66] , [67] , [68] ] and eleven in Asia [ [16] , [17] , [69] , [70] , [71] , [72] , [73] , [74] , [75] , [76] , [77] ]. The population of the studies varied between 17 and 1733 with a mean of 177 participants.…”

CORACLE (COVID-19 liteRAture CompiLEr): A platform for efficient tracking and extraction of SARS-CoV-2 and COVID-19 literature, with examples from post-COVID with respiratory involvement

“…The search for this inquiry yielded a total of 11 publications, with the identified publications compiled into a list of PMIDs and inputted into the CORACLE search interface (Figure 3A, left panel) [10][11][12][13][14][15][16][17][18][19][20] . We retained the default settings allowing for broad inclusion without discrimination based on article type, journal, or publication date, however, these advanced filtering options are available for more nuanced analysis.…”

Pulmonary function trajectories in COVID-19 survivors with- and without pre-existing respiratory disease at three and twelve months after hospital discharge

“…Although in the majority of the patients, these pulmonary function impairments improve over time, still one-third of the COVID-19 patients that were hospitalized during the acute phase of the infection have a reduced diffusion capacity one year later [14]. Acute disease severity, female gender, and the presence of co-morbidities including chronic respiratory disease, diabetes, and hypertension were associated with worse long-term pulmonary function outcomes in hospitalized COVID-19 patients [10,13,14]. Next to the changes in static lung volumes and gas exchange function, impairments in respiratory muscle function have been reported among hospitalized and non-hospitalized COVID-19 patients [15][16][17].…”

“…Some symptoms associated with the post COVID-19 condition have been found to be related to impairments in pulmonary function [8,9]. Long-term pulmonary function impairments mainly include a reduced diffusion capacity, which has been reported in up to 52-56% of the hospitalized COVID-19 patients three months after discharge [10][11][12]. A large prospective cohort study shows that even one year after discharge, persistent pulmonary function damage, i.e.…”