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

Abstract

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. Materials and Methods: 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. Results and discussion: 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. Conclusions: 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.

Clinical characteristics and outcomes of adult patients admitted with COVID-19 in East London: a retrospective cohort analysis

“…A high proportion of patients remain symptomatic at 6–12 weeks after discharge, particularly with fatigue and breathlessness. These findings are similar to a recently reported central London cohort, 9 and to a Belgian study, 19 where a restrictive pattern of lung function was common (38%, N=84/101). This finding was associated with longer, or critical care admission.…”

Radiological and functional lung sequelae of COVID-19: a systematic review and meta-analysis

“…The decision to discharge was made clinically based on patients’ clinical status and per hospital policy in the other 12 studies [ 20 – 31 ]. Among these studies, 13 studies collected data of chest CT [ 17 – 25 , 27 , 29 – 31 ] and 10 studies collected data of PFT [ 17 , 18 , 20 , 22 , 24 – 29 ] from the patients with COVID-19 discharged during their study period. Risk of bias of each study is shown in Additional file 1 : figure S2.…”

“…13 studies were eligible to assess the residual chest CT findings [ 17 – 25 , 27 , 29 – 31 ]. The average approximate follow-up timing after either symptom onset or hospital discharge was 90 days.…”

Assessment of pulmonary arterial circulation 3 months after hospitalization for SARS-CoV-2 pneumonia: Dual-energy CT (DECT) angiographic study in 55 patients

“…Pulmonary functional parameters, including diffusing capacity for carbon monoxide, were not found to be significantly different between patients with normal and abnormal perfusion except for FRC. Recent studies have suggested that reduced DLCO and TLC were the main abnormalities observed after COVID-19 [ 30 , 31 ].…”