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How Is Life After Severe COVID-19?: Functional Cardiopulmonary Outcome and Quality of Life
Maurizio Bernasconi1, Camelia Voinea1, Luca Sardella1
1Pulmonology Division, Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland.
Insights
One year after severe COVID-19, many patients experience persistent cardiopulmonary limitations and significant psychosocial impacts. These long-term effects on physical function and daily life require comprehensive management strategies for COVID-19 survivors.
Area of Science:
- Pulmonology
- Critical Care Medicine
- Rehabilitation Medicine
Background:
- Long-term outcomes of COVID-19-related Acute Respiratory Distress Syndrome (ARDS) are not well-documented, with limited data beyond patient-reported symptoms.
- Severe COVID-19 requiring intensive care unit (ICU) management and mechanical ventilation can lead to persistent health issues.
Purpose of the Study:
- To investigate the 12-month cardiopulmonary function and psychosocial sequelae in patients who experienced severe COVID-19 and required intubation.
- To assess the functional limitations and health perception one year post-ICU admission for COVID-19.
Main Methods:
- A longitudinal cohort study of 39 mechanically ventilated COVID-19 patients from the early pandemic phase.
- Collected data included pulmonary function tests, cardiopulmonary exercise testing, and subjective health perception at 6 and 12 months post-ICU admission.
Main Results:
- At 12 months, 19.3% had moderate pulmonary function alterations and 35.7% showed reduced effort capacity on exercise testing.
- Over 70% reported significant health impairment due to respiratory symptoms, impacting daily activities and work resumption (only 41.7% fully resumed work).
- Health perception scores did not correlate with objective cardiopulmonary or lung function measures.
Conclusions:
- Patients surviving severe COVID-19 ARDS exhibit persistent objective physical limitations and significant psychosocial sequelae 12 months post-ICU.
- The observed health impairment is likely multifactorial, involving physical and psychological components, necessitating integrated care approaches.
- Findings highlight the need for long-term management programs considering the complex and prolonged recovery course for COVID-19 survivors.
Background:
Data on long-term outcomes of COVID-19-related ARDS are scarce and rely largely on patient-reported outcomes. This study aimed to study cardiopulmonary function combined with psychosocial sequelae in a cohort of patients with severe COVID-19 requiring ICU management and intubation, with a follow-up of 12 months.
Research Question:
What are the functional and psychosocial sequelae 1 year after severe COVID-19 requiring ICU management and intubation?
Study Design And Methods:
We studied a longitudinal cohort of 39 mechanically ventilated patients with COVID-19 from the early phase of the pandemic. Pulmonary function test results, cardiopulmonary exercise testing findings, and subjective health perception data from 6 and 12 months after ICU admission were collected.
Results:
Twelve months after COVID-19, 19.3% of participants showed at least moderate alteration in pulmonary function test findings, and 35.7% of participants showed a pathologically reduced effort capacity by cardiopulmonary exercise testing. A considerable impact on daily activities was reported, with only 41.7% of participants being able to resume work entirely and 71% reporting a relevant health impairment resulting from residual respiratory symptoms. The health perception scores did not correlate significantly with the measured cardiopulmonary performance or lung function.
Interpretation:
A persistent objective limitation in physical activity was observed in this population of unvaccinated patients from the early phase of the pandemic, studied for 12 months after recovery from COVID-19-related ARDS. Patients also reported a profound impact on functional autonomy, daily activities, professional life, and health perception. Despite being attributed primarily to residual respiratory symptoms, the observed health impairment is probably multifactorial, with physical and psychological factors playing a role. The prolonged course of the symptoms and the underlying complexity should be considered in future programs for the care of patients who have recovered from COVID-19.
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