Clinical status and lung function 10 weeks after severe SARS-CoV-2 infection

• Published in: Respiratory medicine Vol. 176; p. 106276
• Main Authors: Smet, Jelle, Stylemans, Dimitri, Hanon, Shane, Ilsen, Bart, Verbanck, Sylvia, Vanderhelst, Eef
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-01-2021; Elsevier Limited
• Subjects: Adult; Aged; Blood; Carbon monoxide; Chest; Chi-square test; Computed tomography; Coronaviruses; COVID-19; COVID-19 - complications; COVID-19 - physiopathology; COVID-19 - therapy; Critical Care; Cross-Sectional Studies; Demography; Diabetes; Diagnosis; Editing; Female; Follow-Up Studies; Health Status; Hemoglobin; Humans; Hypertension; Infections; Length of Stay; Lung - diagnostic imaging; Lung - physiopathology; Lungs; Male; Mechanical ventilation; Median (statistics); Middle Aged; Patients; Pneumonia; Population; Pulmonary functions; Recovery of Function; Respiration, Artificial; Respiratory function; Respiratory Function Tests; Severe acute respiratory syndrome coronavirus 2; Short Communication; Statistical analysis; Statistical tests; Subgroups; Time Factors; Tomography, X-Ray Computed; Ventilation; Ventilators; Writing
• ISSN: 0954-6111; 1532-3064
• DOI: 10.1016/j.rmed.2020.106276

Since studies about clinical status after COVID-19 are scarce, we conducted a cross sectional study with assessment of residual symptoms, lung function and chest CT.
During an outpatient follow-up visit, chest CT, pulmonary function and COVID-19 related symptoms were assessed approximately 10 weeks after diagnosis. Demographics, baseline (time of diagnosis) CT score and blood results were collected from patient files. Association between lung function and clinical characteristics (baseline), blood markers (baseline), chest CT (baseline and follow-up) and symptom score (followup) was analysed. Mann-Whitney U tests and Chi squared tests were used for statistical comparison between subgroups with and without restriction.
Two hundred-twenty subjects were evaluated at a median follow-up of 74±12 (SD) days. Median symptom and median CT score at follow-up were 1(IQR=0- 2) and 2(IQR=0-6) respectively. Forty-six percent of patients had normal lung function, while TLC and TLCO below the lower limit of normal were observed in 38% and 22% of subjects respectively. This restrictive pulmonary impairment was associated with length of hospital stay (8 vs 6 days; p=0.003), admission to the intensive care unit (27% vs 13%;p=0.009), and invasive mechanical ventilation (10% vs 0.7%;p=0.001), but not with symptom score or CT score at baseline and follow-up.
Fifty-four percent of COVID-19 survivors had abnormal lung function 10 weeks after diagnosis. Restriction was the most prevalent pulmonary function, with the more critically ill patients being more prone to this condition. Yet, restriction could not be linked with abnormal imaging results or residual symptoms.
•220 patients were assessed 10 weeks after severe COVID-19.•54% of patients had abnormal lung function.•Restriction was the most frequently observed pattern of lung function impairment.•Restriction at follow-up was associated with more severe acute COVID-19.•No correlation was observed between restriction at follow up and chest CT.