Residual pulmonary infiltrates, symptoms and diffusion impairment at 1‐year after severe COVID‐19 infection have different associated factors

• Published in: Journal of internal medicine Vol. 294; no. 1; pp. 69 - 82
• Main Authors: Menéndez, Rosario, Méndez, Raúl, Latorre, Ana, González‐Jiménez, Paula, Peces‐Barba, Germán, Molina, María, España, Pedro Pablo, García, Estela, Consuegra‐Vanegas, Angélica, Pando‐Sandoval, Ana, Panadero, Carolina, Figueira‐Gonçalves, Juan Marco, De la Rosa, David, Sibila, Oriol, Martínez‐Pitarch, María Dolores, Toledo, Nuria, Cejudo, Pilar, Almonte‐Batista, Wanda, Macías‐Paredes, Abigail, Badenes, Diana, Pérez‐Rodas, Eli Nancy, Lázaro, Javier, Quirós, Sarai, Cordovilla, Rosa, Cano‐Pumarega, Irene, Torres, Antoni
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01-07-2023
• Subjects: Age; Asthma; Carbon monoxide; Comorbidity; Complications; Coronaviruses; Corticoids; Corticosteroids; COVID-19; Female; Females; Humans; Impairment; Lung; Lungs; Male; Mechanical ventilation; Pneumonia; Radiology; RECOVID; Respiratory diseases; SARS-CoV-2; SEPAR; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Sex; Signs and symptoms; Viral diseases; COVID-19; RECOVID; SARS-CoV-2; SEPAR
• ISSN: 0954-6820; 1365-2796
• DOI: 10.1111/joim.13642

Introduction
After severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) pneumonia, patients may show lung sequelae on radiology and functional impairment at the 1‐year follow‐up. We aimed to describe the persistence of symptoms, radiological alterations, or reduced diffusing capacity of the lung for carbon monoxide (DLCO) at 1‐year follow‐up in patients from the Spanish Registry RECOVID.
Methods
RECOVID collected symptom and radiological and functional lung tests data on hospitalized patients with coronavirus disease 2019 during the acute phase and at the 6‐ and 12‐month follow‐up visits.
Results
Of the 2500 enrolled survivors (90% admitted to the ward), 1874 had follow‐up visits for up to a year. Of these, 42% continued to present with symptoms, 27% had radiological sequelae and 31% had reduced DLCO. Independently associated factors included female sex, asthma and the requirement for invasive or non‐invasive mechanical ventilation. Complete radiological resolution was 72.2% at 12 months; associated factors with incomplete recovery were age, male sex, oxygen or respiratory support, corticosteroids and an initial SpO2/FiO2 <450 or CURB‐65 ≥2. Reduced DLCO was observed in 31% of patients at 12 months; associated factors were older age, female sex, smoking habit, SpO2/FiO2 <450 and CURB‐65 ≥2 and the requirement of respiratory support.At 12 months, a proportion of the asymptomatic patients showed reduced DLCO (9.5%), radiological findings (25%) or both (11%).
Conclusions
The factors associated with symptom persistence, incomplete radiological resolution and DLCO <80% differed according to age, sex, comorbidities and respiratory support. The burden of symptoms, reduced DLCO and incomplete radiological resolution were considerable in patients with SARS‐CoV‐2 pneumonia at the 1‐year follow‐up after hospitalisation.