COVID-19 6 months after hospital discharge: pulmonary function impairment and its heterogeneity

Milanese, Manlio; Anselmo, Marco; Buscaglia, S; Garra, Luca; Goretti, Riccardo; Parodi, Lionello; Riccio, Giovanni; Tassara, Rodolfo; Gnerre, Paola

doi:10.1183/23120541.00196-2021

Cited by 9 publications

(14 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our study found that up to 34% of the HCWs with COVID-19 had diffusion impairment at 13 months after discharge. Similar to the previous findings, lung is the organ most affected by infection of SARS-COV-2, and former studies also found abnormal lung function in patients with COVID-19 after discharge or symptom onset (Huang et al, 2021;Milanese et al, 2021;Shah et al, 2021). The study in Jin Yin-tan Hospital in China reported that 22~56% of patients with various severity scales of COVID-19 had pulmonary diffusion abnormality (DLCO <80%, % of predicted) at six months after symptom onset (Huang et al, 2021).…”

Section: Discussionsupporting

confidence: 82%

“…The study in Jin Yin-tan Hospital in China reported that 22~56% of patients with various severity scales of COVID-19 had pulmonary diffusion abnormality (DLCO <80%, % of predicted) at six months after symptom onset (Huang et al, 2021). A study in Italy also found that 40% of the patients with COVID-19 had DLCO impairment at 6 months after hospital discharge (Milanese et al, 2021). Another prospective cohort in Canada suggested that more than 50% of the patients with COVID-19 had lung function impairment at 12 weeks after symptom onset (Shah et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Recovery of functional fitness, lung function, and immune function in healthcare workers with nonsevere and severe COVID-19 at 13 months after discharge from the hospital: a prospective cohort study

Xiong

Cao

et al. 2022

International Journal of Infectious Diseases

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Recovery of functional fitness, lung function, and immune function in healthcare workers with nonsevere and severe COVID-19 at 13 months after discharge from the hospital: a prospective cohort study

Xiong

Cao

et al. 2022

International Journal of Infectious Diseases

View full text Add to dashboard Cite

“…The studies were mainly conducted in Asia (16, 53.3%) and Europe (13, 43.3%), and all studies were prospective cohort studies. Among the 30 studies, 25 (83.3%) had follow-up PFT data [ 19 , 20 , 33 – 35 , 37 , 38 , 40 – 44 , 46 – 49 , 51 , 53 – 60 ], and 22 (73.3%) had follow-up chest CT data [ 19 , 20 , 34 – 36 , 38 , 39 , 42 – 48 , 50 – 53 , 56 , 57 , 59 , 60 ]. The eligibility criteria varied between studies, but most studies included patients with confirmed COVID-19 who were successfully treated and discharged from the study hospitals.…”

Section: Resultsmentioning

confidence: 99%

“…However, some studies did not present data on the severity of index infection [ 33 , 54 ]. The included studies could be approximately classified into two groups according to their follow-up durations: 18 studies with a 6-month follow-up [ 33 , 34 , 36 , 37 , 39 – 45 , 47 , 49 – 51 , 53 , 54 , 57 ] and 12 studies with a 12-month follow-up [ 19 , 20 , 35 , 38 , 46 , 48 , 52 , 55 , 56 , 58 – 60 ] (Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

Pulmonary function and chest computed tomography abnormalities 6–12 months after recovery from COVID-19: a systematic review and meta-analysis

2022

View full text Add to dashboard Cite

Background Some coronavirus disease 2019 (COVID-19) survivors experience prolonged and varying symptoms, a condition termed post-acute COVID-19 syndrome (PACS). However, the prevalence of chronic pulmonary sequelae of PACS during long-term follow-up remains unclear. Several studies have examined this issue and reported heterogeneous results. Methods We conducted a systematic review and meta-analysis using a random-effects model to estimate the pooled prevalence of the pulmonary sequelae of COVID-19, as demonstrated by pulmonary function testing (PFT) and chest computed tomography (CT) performed at least 6 months after initial infection. PubMed, Embase, and Cochrane Library databases were searched from January 1, 2020 to December 31, 2021 to identify related studies. We investigated whether the prevalence of pulmonary sequelae decreased over time and attempted to identify the factors associated with their development by performing multiple subgroup and meta-regression analyses. Results Of the 18,062 studies identified, 30 met our eligibility criteria. Among these studies, 25 and 22 had follow-up PFT and chest CT data, respectively. The follow-up durations were approximately 6 and 12 months in 18 and 12 studies, respectively. Impaired diffusion capacity was the most common abnormality on PFT (pooled prevalence 35%, 95% confidence interval [CI] 30–41%) with a prevalence of 39% (95% CI 34–45%) and 31% (95% CI 21–40%) in the 6-month and 12-month follow-up studies, respectively (P = 0.115). Restrictive pulmonary dysfunction evident as reduced forced vital capacity was less frequent (pooled prevalence 8%, 95% CI 6–11%); however, its prevalence was lower in the 12-month follow-up studies than in the 6-month follow-up studies (5% [95% CI 3–7%] vs. 13% [95% CI 8–19%], P = 0.006). On follow-up chest CT, the pooled prevalence of persistent ground-glass opacities and pulmonary fibrosis was 34% (95% CI 24–44%) and 32% (95% CI 23–40%), respectively, and the prevalence did not decrease over time. As every meta-analysis showed significant between-study heterogeneity, subgroup and meta-regression analyses were performed to identify potential effect modifiers; the severity of index infection was associated with the prevalence of impaired diffusion capacity and pulmonary fibrosis. Conclusions A substantial number of COVID-19 survivors displayed pulmonary sequelae as part of PACS. Except for restrictive pulmonary dysfunction, the prevalence of these sequelae did not decrease until 1 year after initial infection. Considering the association between the severity of acute COVID-19 and risk of pulmonary sequelae, patients who recover from severe COVID-19 require close respiratory follow-up. Systematic review registration number PROSPERO CRD42021234357

show abstract

“…To be consistent and comparable with our earlier publication (Wu et al, 2021), we excluded those studies without data on FVC and/or DLCO values <80% of predicted. This might cause some false positive results considering the mean age of included patients is over 50 (van den Borst et al, 2020;Barisione and Brusasco, 2021;Milanese et al, 2021). In addition, pre-existing comorbidities for most COVID-19 patients are not known, which might cause certain…”

Section: Discussionmentioning

confidence: 99%

Respiratory Outcomes in Patients Following COVID-19-Related Hospitalization: A Meta-Analysis

Guo

Jiang

Liu

et al. 2021

Front. Mol. Biosci.

View full text Add to dashboard Cite

Background: To determine the respiratory outcomes in patients following COVID-19-related hospitalization.Methods: Systematic review and meta-analysis of the literature.Results: Forced vital capacity (FVC, % of predicted): 0–3 months post discharge: 96.1, 95% CI [82.1–110.0]; 3–6 months post discharge: 99.9, 95% CI [84.8, 115.0]; >6 months post discharge: 97.4, 95% CI [76.8–118.0]. Diffusing capacity of the lungs for carbon monoxide (DLCO, % of predicted): 0–3 months post discharge: 83.9, 95% CI [68.9–98.9]; 3–6 months post discharge: 91.2, 95% CI [74.8–107.7]; >6 months post discharge: 97.3, 95% CI [76.7–117.9]. Percentage of patients with FVC less than 80% of predicted: 0–3 months post discharge: 10%, 95% CI [6–14%]; 3–6 months post discharge: 10%, 95% CI [2–18%]; >6 months post discharge: 13%, 95% CI [8–18%]. Percentage of patients with DLCO less than 80% of predicted: 0–3 months post discharge: 48%, 95% CI [41–56%]; 3–6 months post discharge: 33%, 95% CI [23–44%]; >6 months post discharge: 43%, 95% CI [22–65%].Conclusion: The meta-analysis confirms a high prevalence of persistent lung diffusion impairment in patients following COVID-19-related hospitalization. Routine respiratory follow-up is thus strongly recommended.

show abstract

COVID-19 6 months after hospital discharge: pulmonary function impairment and its heterogeneity

Abstract: Until now, reports about pulmonary function in previously hospitalised subjects for COVID-19 are at discharge [1] or at 3–4 months [2–4]. The first study at 6 months is that of Huang et al . [5], enrolling 1733 discharged subjects, 349 of them underwent a pulmonary function study.

Cited by 9 publications

References 14 publications

Recovery of functional fitness, lung function, and immune function in healthcare workers with nonsevere and severe COVID-19 at 13 months after discharge from the hospital: a prospective cohort study

Recovery of functional fitness, lung function, and immune function in healthcare workers with nonsevere and severe COVID-19 at 13 months after discharge from the hospital: a prospective cohort study

Pulmonary function and chest computed tomography abnormalities 6–12 months after recovery from COVID-19: a systematic review and meta-analysis

Respiratory Outcomes in Patients Following COVID-19-Related Hospitalization: A Meta-Analysis

Contact Info

Product

Resources

About