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A prospective study of 12-week respiratory outcomes in COVID-19-related hospitalisations
Aditi S Shah1, Alyson W Wong1, Cameron J Hague2
1Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Insights
Many COVID-19 survivors experience persistent respiratory issues 12 weeks post-infection. Abnormal pulmonary function and chest CT scans are common, underscoring the need for long-term respiratory monitoring.
Area of Science:
- Pulmonology
- Infectious Diseases
- Radiology
Background:
- The long-term respiratory health consequences of COVID-19 are not fully understood.
- Persistent symptoms and organ damage are reported in some patients after acute infection.
Purpose of the Study:
- To characterize persistent respiratory abnormalities 12 weeks after COVID-19 symptom onset in hospitalized patients.
- To identify clinical predictors of these long-term respiratory outcomes.
Main Methods:
- Prospective assessment of clinical, radiological, and pulmonary function parameters.
- Chest CT imaging and pulmonary function tests (including DLCO) were performed at 12 weeks.
- Correlation analysis between acute phase treatments and long-term outcomes.
Main Results:
- 58% of patients exhibited at least one abnormal pulmonary function variable.
- 88% showed abnormal findings on chest CT scans.
- Increased duration of oxygen supplementation during acute COVID-19 was strongly associated with reduced DLCO-% predicted and higher CT scores.
Conclusions:
- A significant proportion of hospitalized COVID-19 patients have ongoing respiratory morbidity 12 weeks post-onset.
- Chest imaging and pulmonary function tests reveal persistent abnormalities.
- Oxygen requirements during acute illness predict poorer long-term respiratory outcomes, emphasizing the need for targeted follow-up and treatment strategies.
Abstract:
The long-term respiratory morbidity of COVID-19 remains unclear. We describe the clinical, radiological and pulmonary function abnormalities that persist in previously hospitalised patients assessed 12 weeks after COVID-19 symptom onset, and identify clinical predictors of respiratory outcomes. At least one pulmonary function variable was abnormal in 58% of patients and 88% had abnormal imaging on chest CT. There was strong association between days on oxygen supplementation during the acute phase of COVID-19 and both DLCO-% (diffusion capacity of the lung for carbon monoxide) predicted and total CT score. These findings highlight the need to develop treatment strategies and the importance of long-term respiratory follow-up after hospitalisation for COVID-19.
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