Pulmonary function three to five months after hospital discharge for COVID-19: a single centre cohort study

Abstract

Some COVID-19 survivors suffer from persistent pulmonary function impairment, but the extent and associated factors are unclear. This study aimed to characterize pulmonary function impairment three to five months after hospital discharge and the association with disease severity. Survivors of COVID-19 after hospitalization to the VieCuri Medical Centre between February and December 2020 were invited for follow-up, three to five months after discharge. Dynamic and static lung volumes, respiratory muscle strength and diffusion capacity were measured. The cohort comprised 257 patients after a moderate (n = 33), severe (n = 151) or critical (n = 73) COVID-19 infection with a median follow-up of 112 days (interquartile range 96–134 days). The main sequelae included reduced diffusion capacity (36%) and reduced maximal expiratory pressure (24%). Critically ill patients were more likely to have reduced diffusion capacity than moderate (OR 8.00, 95% CI 2.46–26.01) and severe cases (OR 3.74, 95% CI 1.88–7.44) and lower forced vital capacity (OR 3.29, 95% CI 1.20–9.06) compared to severe cases. Many COVID-19 survivors, especially after a critical disease course, showed pulmonary function sequelae, mainly DLCO impairments, three to five months after discharge. Monitoring is needed to investigate the persistence of these symptoms and the longer-term implications of the COVID-19 burden.

Post-Discharge Spirometry Evaluation in Patients Recovering from Moderate-to-Critical COVID-19: A Prospective Cohort Study

“…44,47 Corticosteroid treatment was linked to better lung function recovery, 33,47 while this was not observed with other treatment modalities. 39 Overall, our study ndings are consistent with most of other studies.…”

“…China have respectively reported signi cantly lower dynamic lung volumes in patients with more severe illness, 31,38 while another study in the Netherlands found only FVC to be signi cantly lower in such cases. 39 Additional studies have shown that for individuals post-COVID-19, spirometry indices were not signi cantly different from the healthy population, 40 those with other viral upper respiratory tract infections, 41 or the same cohort of patients one year before the infection. 42 A review by Thomas et al further concluded that spirometry indices are often well-preserved in COVID-19, without being signi cantly affected by illness severity.…”

Voice handicap and voice-related quality of life in COVID-19 patients

“…Krueger et al assessed lung function in 257 patients presenting mean COVID-19 duration of 112 days and observed reduced FEP and FIP in 24% and 9% of patients, respectively. 29 …”

Acute and post-acute respiratory complications of SARS-CoV-2 infection: population-based cohort study in South Korea and Japan

“…Some previous studies have examined the relationship between COVID-19 and respiratory complications. However, previous research encompassed countries such as Brazil ( n = 88) 10 , Palestine ( n = 705) 11 , and Netherlands ( n = 257) 12 , with small cohorts and without a general population group as controls or influenza cohort as an external comparator. In addition, previous studies did not consider the subtypes of specific respiratory diseases, vaccinations, and severity of COVID-19 on the association between respiratory outcomes and SARS-CoV-2 infections 13 .…”