Prospective longitudinal evaluation of hospitalised COVID-19 survivors 3 and 12 months after discharge

Abstract

BackgroundLong-term outcome data of COVID-19 survivors are needed to understand their recovery trajectory and additional care needs.MethodsA prospective observational multi-centre cohort including adults hospitalised with COVID-19 from March through May 2020. Work-up at 3 and 12 months following admission consisted of clinical review, pulmonary function testing, 6-min walking distance (6MWD), muscle strength, chest computed tomography (CT), and quality of life questionnaires. We evaluated factors correlating with recovery by linear mixed effects modelling.ResultsOf 695 patients admitted, 299 and 226 returned at 3 and 12 months, respectively (median age 59 years, 69% male, 31% severe disease). About 1/2 and 1/3 reported fatigue, dyspnoea and/or cognitive impairment at 3 and 12 months, respectively. Reduced 6MWD and quadriceps strength were present in 20% and 60% at 3 months versus 7% and 30% at 12 months. A high anxiety score and body mass index correlated with poor functional recovery. At 3 months, diffusing capacity for carbon monoxide (DLCO) and total lung capacity were below the lower limit of normal in 35% and 18%, decreasing to 21% and 16% at 12 months; predictors of poor DLCO recovery were female sex, pre-existing lung disease, smoking, and disease severity. Chest CT improved over time; 10% presented non-progressive fibrotic changes at 1 year.ConclusionMany COVID-19 survivors, especially with severe disease, experienced limitations at 3 months. At 1 year, the majority showed improvement to almost complete recovery. To timely identify additional care or rehabilitation needs, we recommend a multidisciplinary follow-up visit following COVID-19 admission.

Physical recovery across care pathways up to 12 months after hospitalization for COVID-19: A multicenter prospective cohort study (CO-FLOW)

“…This hypothesis is supported by a recent study by Lorent and colleagues, reporting a lower proportion of patients with impaired 6MWD (16/222, 8%) than patients with impaired quadriceps strength (31/222, 32%) at 12 months after hospitalization for COVID-19. 38 However, because the reference values that we have used for the different physical outcomes were obtained from different study samples, as well as that different reference values for 6MWT were used by Lorent and colleagues, 38 the findings should be interpreted with caution.…”

Long-COVID severe refractory cough: discussion of a case with 6-week longitudinal cough characterization

“…The clinical practice guidelines for chronic cough should perhaps be followed [ 1 7 8 9 ]. However, as the clinical presentations and symptoms of long COVID are variable [ 1 13 ], the approach should be individualised. Comorbidities that may potentially cause dyspnoea should be actively evaluated.…”

Imaging Severity COVID-19 Assessment in Vaccinated and Unvaccinated Patients: Comparison of the Different Variants in a High Volume Italian Reference Center

“…Their identification and the volumetric quantification may allow an easier classification in terms of gravity, extent and progression of the disease. Moreover, this may provide a high-impact tool to enhance awareness of the severity of COVID-19 pneumonia [ 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 ].…”