Determinants of recovery from post-COVID-19 dyspnoea: analysis of UK prospective cohorts of hospitalised COVID-19 patients and community-based controls

Vivaldi, Giulia; McAuley, Hamish; Harrison, Ewen M; Lone, Nazir; Quint, Jennifer; Marks, Michael; Poinasamy, K.; Raman, Betty; Evans, Rachael A.; Abel, Kathryn M.; Adamali, Huzaifa; Adeloye, Davies; Adeyemi, Oluwafikayo S; Adrego, R.; Jiménez, Laura; Ahmad, Shazaad; Haider, Nafees; Ahmed, Rizwan; Ahwireng, N.; Ainsworth, Mark; Al-Sheklly, Bashar; Alamoudi, A.; Ali, Muhammad; Aljaroof, M; All, A.M.; Allan, Louise; Allen, R J; Allerton, L.; Allsop, Lynne; Almeida, P.; Altmann, Doris; Corral, Maria Alvarez; Amoils, S.; Anderson, Debra; Antoniades, C; Arbane, Gill; Arias, Ana; Armour, Chérie; Armstrong, Lará; Armstrong, Natalie; Arnold, David; Arnold, Horace D.; Ashish, Abdul; Ashworth, Andrew; Ashworth, Mark; Aslani, Shahab; Assefa-Kebede, H.; Atkin, Catherine; Atkin, Philip A.; Aul, Raminder; Aung, Htin; Austin, Luke; Avram, Cristina; Ayoub, A.; Babores, Marta; Baggott, Rob; Bagshaw, J.; Baguley, David; Bailey, L. Charles; Baillie, J Kenneth; Bain, SC; Bakali, M; Bakau, M; Baldry, Eileen; Baldwin, Danielle; Baldwin, Molly; Clive, Ballard; Banerjee, Amitava; Bang, B.; Barker, Ruth E; Barman, L.; Barratt, Shaney; Barrett, Fiona; Basire, D.; Basu, Neil; Bates, Michelle; Bates, Andrew; Batterham, Rachel L.; Baxendale, Helen; Bayes, Hannah; Beadsworth, Michael; Beckett, P.; Beggs, M.; Begum, Masrath; Beirne, Paul; Bell, Derek; Bell, Robert M.; Bennett, Katherine A.; Beranova, Eva; Bermperi, Areti; Berridge, A.; Berry, Colin; Betts, Sarah; Bevan, Emily; Bhui, Kam; Bingham, M.; Birchall, Kathrine; Bishop, Lisa; Bisnauthsing, Karen; Blaikely, J; Bloss, Angela; Bolger, Aidan P.; Bolton, Charlotte E.; Bonnington, J; Botkai, A; Bourne, C.; Bourne, Michelle; Bramham, Kate; Brear, Lucy; Breen, Gerome; Breeze, Janis L.; Briggs, Andrew; Bright, Eddie A; Brightling, Christopher; Brill, Simon; Brindle, K; Broad, Lauren; Broadley, Andrew; Brookes, C.; Broome, Marion E.; Brown, Ammani; Brown, Jeremy; Brown, Michael J.; Brown, Victoria Tzortziou; Brugha, Traolach; Brunskill, Nigel; Buch, Maya H; Buckley, Philip; Bularga, Anda; Bullmore, Edward T.; Burden, L.; Burdett, Teresa; Burn, D; Burns, Graham; Burns, Angus C; Busby, John; Butcher, R.; Butt, Adeel A.; Byrne, Suzanne; Cairns, Paula; Calder, P.C.; Calvelo, E.; Carborn, H.; Card, Brittany; Carr, Christine; Carr, Loretta; Carson, Gail; Carter, P.; Casey, A; Cassar, Mark Philip; Cavanagh, Jorunn Pauline; Chablani, Manish; Chalder, Trudie; Chalmers, James D.; Chambers, Robert; Chan, Francis K.L.; Channon, K.M.; Chapman, Katie; Charalambou, Amanda; Chaudhuri, Nazia; Checkley, Anna M.; Chen, J.; Cheng, Yu; Chetham, L.; Childs, C.; Chilvers, Edwin R.; Chinoy, Hector; Chiribiri, A.; Chong-James, K; Choudhury, Gourab; Choudhury, Noura J.; Chowienczyk, P.; Christie, C. D. C.; Chrystal, M.; Clark, Diane; Clark, Collin M.; Clarke, Jennifer; Clohisey, Sara; Coakley, G.; Coburn, Z.; Coetzee, Samantha; Cole, Jacob; Coleman, Christopher M.; Conneh, F.; Connell, D; Connolly, Bronwen; Connor, L.; Cook, Amanda; Cooper, Brendan; Cooper, Jackie A.; Cooper, Sheldon C.; Copeland, D.; Cosier, Tracey; Coulding, Martina; Coupland, Cherry; Cox, Ellie; Craig, Tom; Crisp, Philippe; Cristiano, Daniele; Crooks, Michael G.; Cross, Andy; Cruz, Igor; Cullinan, Paul; Cuthbertson, Daniel J; Daines, Luke; Dalton, M.; Daly, Patricia; Daniels, A.; Dark, Paul; Dasgin, Joanne; David, Abel P.; David, Clara; Davies, Elin Haf; Davies, Ffyon; Davies, Gwyn; Davies, Kim; Davies, Matthew J.; Dawson, Jennifer; Daynes, Enya; Soyza, Anthony De; Deakin, B; Deans, Andrew R.; Deas, Catherine; Deery, Joanne; Defres, Sylviane; Dell, Amanda; Dempsey, Katherine; Denneny, Emma; Dennis, John; Dewar, Amy; Dharmagunawardena, R; Diar-Bakerly, N.; Dickens, Chris; Dipper, Alexandra; Diver, Sarah; Diwanji, S.N.; Dixon, Michael J.; Djukanović, Ratko; Dobson, Hannah; Dobson, Susan L; Docherty, Annemarie B; Donaldson, A; Dong, T.; Dormand, Natalie; Dougherty, Andrew; Dowling, Rowan; Drain, S; Draxlbauer, K.; Drury, Kay; drury, H.J.C.; Dulawan, P.; Dunleavy, A.; Dunn, S.; Dupont, C.; Earley, J.; Easom, Nicholas; Echevarria, Carlos; Edwards, Sarah; Edwardson, Charlotte L.; El-Taweel, Hosni; Elliott, Angela; Elliott, Katharine; Ellis, Yvette; Elmer, Anne; Elneima, Omer; Evans, D; Evans, Helen; Evans, Joanne; Evans, R.; Evans, Teriann; Evenden, C.; Evison, Lynsey; Fabbri, L.; Fairbairn, Sara; Fairman, Andrea D.; Fallon, K; Faluyi, David; Favager, C; Fayzan, T.; Featherstone, Jonathan; Felton, Timothy; Finch, Joanne; Finney, Simon J.; Finnigan, J.; Finnigan, L.; Fisher, Helen; Fletcher, Simon; Flockton, R.; Flynn, Maura; Foot, H.; Foote, Dru; Ford, Amber; Forton, Daniel; Fraile, Eva; Francis, Charlotte; Francis, Rebecca; Francis, Sarah L.; Frankel, Adam; Fraser, Emily; Free, Robert C; French, Nigel P.; Fu, Xiaotong; Fuld, Jonathan; Furniss, James J; Garner, Linda; Gautam, Nandan; Geddes, John; George, Jenny S.; George, Peter M.; Gibbons, Michael; Gill, Mandy; Gilmour, Lesley; Gleeson, Fergus; Glossop, Jodie; Glover, Sarah C.; Goodman, Nigel; Goodwin, C W; Gooptu, Bibek; Gordon, Howard S.; Gorsuch, T; Greatorex, M.; Greenhaff, Paul L.; Greenhalf, William; Greenhalgh, Alan; Greening, Neil; Greenwood, J; Gregory, H.; Gregory, R.; Grieve, Douglas; Griffin, Denise; Griffiths, Lori; Guerdette, A.-M.; Guio, B. 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doi:10.1016/j.lanepe.2023.100635

Cited by 10 publications

(4 citation statements)

References 32 publications

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“…The physical health conditions included fatigue, dyspnea, chest pain, myalgia, and cough, meanwhile, mental health conditions such as insomnia, panic disorder, cognitive blunting, and depressive disorder [ 3 , 5 , 27 ]. Zheng et al reported a higher Medical Research Council (MRC) dyspnoea score in patients with CVD, which was consistent with increased odds of worsening dyspnoea over 1 year in those with CVD (OR 1.69; 95% CI 1.27–2.25) [ 32 ].…”

Section: Resultsmentioning

confidence: 84%

Cardiovascular diseases as risk factors of post-COVID syndrome: a systematic review

Sha’ari,

Ismail,

Abdul Aziz

et al. 2024

BMC Public Health

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Background A growing proportion of people experience incomplete recovery months after contracting coronavirus disease 2019 (COVID-19). These COVID-19 survivors develop a condition known as post-COVID syndrome (PCS), where COVID-19 symptoms persist for > 12 weeks after acute infection. Limited studies have investigated PCS risk factors that notably include pre-existing cardiovascular diseases (CVD), which should be examined considering the most recent PCS data. This review aims to identify CVD as a risk factor for PCS development in COVID-19 survivors. Methods Following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) checklist, systematic literature searches were performed in the PubMed, Scopus, and Web of Science databases from the earliest date available to June 2023. Data from observational studies in English that described the association between CVD and PCS in adults (≥ 18 years old) were included. A minimum of two authors independently performed the screening, study selection, data extraction, data synthesis, and quality assessment (Newcastle-Ottawa Scale). The protocol of this review was registered under PROSPERO (ID: CRD42023440834). Results In total, 594 studies were screened after duplicates and non-original articles had been removed. Of the 11 included studies, CVD including hypertension (six studies), heart failure (three studies), and others (two studies) were significantly associated with PCS development with different factors considered. The included studies were of moderate to high methodological quality. Conclusion Our review highlighted that COVID-19 survivors with pre-existing CVD have a significantly greater risk of developing PCS symptomology than survivors without pre-existing CVD. As heart failure, hypertension and other CVD are associated with a higher risk of developing PCS, comprehensive screening and thorough examinations are essential to minimise the impact of PCS and improve patients’ disease progression.

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Section: Resultsmentioning

confidence: 84%

Cardiovascular diseases as risk factors of post-COVID syndrome: a systematic review

Sha’ari,

Ismail,

Abdul Aziz

et al. 2024

BMC Public Health

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“…In contrast, O 2 desaturation during exercise, combining pulmonary and cardiovascular capacities, improved in the early period, but there was no improvement in dyspnoea. Our analysis has limited power (27 patients), but we cannot exclude other possible causes such as comorbid anxiety and depression, which predict lower dyspnoea recovery rate after COVID-19 42,43 , functional dyspnoea 44 possibly due to conditioned breathlessness 45 , lethargy due to patients not having completely recovered their pre-COVID-19 state of health 33 .…”

Section: Discussionmentioning

confidence: 99%

Persistent disabilities 28 months after COVID-19 hospitalization, a prospective cohort study

Renaud,

Chocron,

Reverdito

et al. 2024

ERJ Open Res

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BackgroundLimited data are available on long-term respiratory disabilities in patients following acute COVID-19.Patients and MethodsThis prospective, monocentric, observational cohort study included patients admitted to our hospital with acute COVID-19 between March 3 and April 24, 2020. Clinical, functional, and radiological data were collected up to 28 months after hospital discharge.ResultsAmong 715 patients hospitalized for COVID-19, 493 (69.0%) were discharged alive. We could access complete medical records for 268/493 patients (54.4%); 138/268 (51.5%) exhibited persistent respiratory symptoms and agreed with the data collection and follow-up. Patients were predominantly male (64.5%), with a mean (±sd) age of 58.9±15.3 years. At the last follow-up, the leading symptoms were asthenia (31.5%), dyspnoea (29.8%), and neuropsychological symptoms (17.7%). Lung function improved up to the last visit. Mean diffusing capacity of the lung for carbon monoxide (DLCO) was 77.8% of predicted value, total lung capacity (TLC) 83.5%, and O2desaturation during exercise (O2desaturation) −2.3%. While DLCO improved over the entire period, TLC improved in the early phase and O2desaturation in the late phase. Except for those with lung comorbidities, only one patient presented with minor functional and chest radiological alterations at 28-months.ConclusionPatients with acute COVID-19 discharged alive showed improved clinical symptoms, lung function parameters and radiological signs up to 28 months post infection. Persistent symptoms consisted mainly of asthenia and dyspnoea, with lung function returning to normal. One patient without prior respiratory issues exhibited moderate pulmonary fibrosis.

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“…However, this has been partially mitigated by using external cohorts or healthy controls to examine certain hypotheses. 29 …”

Section: What Are the Main Strengths And Weaknesses?mentioning

confidence: 99%

Cohort Profile: Post-Hospitalisation COVID-19 (PHOSP-COVID) study

Elneima,

McAuley,

Leavy

et al. 2023

International Journal of Epidemiology

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Determinants of recovery from post-COVID-19 dyspnoea: analysis of UK prospective cohorts of hospitalised COVID-19 patients and community-based controls

Cited by 10 publications

References 32 publications

Cardiovascular diseases as risk factors of post-COVID syndrome: a systematic review

Cardiovascular diseases as risk factors of post-COVID syndrome: a systematic review

Persistent disabilities 28 months after COVID-19 hospitalization, a prospective cohort study

Cohort Profile: Post-Hospitalisation COVID-19 (PHOSP-COVID) study

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