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Persistent disabilities 28 months after COVID-19 hospitalisation, a prospective cohort study
Bertrand Renaud1,2,3, Richard Chocron4,5,3, Guillaume Reverdito5,6
1Unité d'Explorations Fonctionnelles Respiratoires et du Sommeil, Hôpital Européen Georges-Pompidou, AP-HP, Paris, France.
Insights
Long COVID can cause persistent respiratory issues, but lung function generally improves over 28 months. Most patients recover, with few showing lasting lung damage after COVID-19 recovery.
Area of Science:
- Pulmonology
- Infectious Diseases
- Epidemiology
Background:
- Limited data exist on long-term respiratory disabilities after acute COVID-19.
- Understanding post-COVID-19 respiratory sequelae is crucial for patient management.
Purpose of the Study:
- To investigate long-term respiratory outcomes in patients hospitalized with acute COVID-19.
- To assess clinical, functional, and radiological changes up to 28 months post-discharge.
Main Methods:
- Prospective, observational cohort study of hospitalized COVID-19 patients.
- Data collection included clinical, functional (lung function tests), and radiological assessments up to 28 months.
- Analysis of 268 patients with complete medical records.
Main Results:
- 69% of hospitalized patients were discharged alive; 51.5% reported persistent symptoms like asthenia and dyspnea.
- Lung function, including diffusing capacity of the lung for carbon monoxide (DLCO) and total lung capacity (TLC), improved over time.
- Most patients showed normal lung function and minimal radiological changes at 28 months, with one case of moderate pulmonary fibrosis.
Conclusions:
- COVID-19 survivors show significant improvement in respiratory symptoms and lung function up to 28 months.
- Persistent symptoms are mainly asthenia and dyspnea, but lung function tends to normalize.
- Long-term respiratory disability is uncommon in patients without prior lung comorbidities.
Background:
Limited data are available on long-term respiratory disabilities in patients following acute COVID-19.
Patients And Methods:
This prospective, monocentric, observational cohort study included patients admitted to our hospital with acute COVID-19 between 12 March and 24 April 2020. Clinical, functional and radiological data were collected up to 28 months after hospital discharge.
Results:
Among 715 patients hospitalised for COVID-19, 493 (69.0%) were discharged alive. We could access complete medical records for 268 out of 493 patients (54.4%); 138 out of 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 (D LCO) was 77.8% of predicted value, total lung capacity (TLC) was 83.5% and O2 desaturation during exercise (O2 desaturation) was 2.3%. While D LCO improved over the entire period, TLC improved in the early phase and O2 desaturation in the late phase. Except for those with lung comorbidities, only one patient presented with minor functional and chest radiological alterations at 28 months.
Conclusion:
Patients 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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