Clinical Epidemiology and Ageing

Respiratory recovery trajectories after severe-to-critical COVID-19: a 1-year prospective multicentre study.

Schlemmer F, Valentin S, Boyer L, Guillaumot A, Chabot F, Dupin C, Le Guen P, Lorillon G, Bergeron A, Basille D, Delomez J, Andrejak C, Bonnefoy V, Goussault H, Assié J-B, Choinier P, Ruppert A-M, Cadranel J, Mennitti MChiara, Roumila M, Colin C, Günther S, Sanchez O, Gille T, Sésé L, Uzunhan Y, Faure M, Patout M, Morelot-Panzini C, Laveneziana P, Zysman M, Blanchard E, Raherison-Semjen C, Giraud V, Giroux-Leprieur E, Habib S, Roche N, Dinh-Xuan ATuan, Sifaoui I, Brillet P-Y, Jung C, Boutin E, Layese R, Canoui-Poitrine F, Maitre B Eur Respir J. 2023;61(4).

BACKGROUND: Survivors of severe-to-critical coronavirus disease 2019 (COVID-19) may have functional impairment, radiological sequelae and persistent symptoms requiring prolonged follow-up. This pragmatic study aimed to describe their clinical follow-up and determine their respiratory recovery trajectories, and the factors that could influence them and their health-related quality of life.

METHODS: Adults hospitalised for severe-to-critical COVID-19 were evaluated at 3 months and up to 12 months post-hospital discharge in this prospective, multicentre, cohort study.

RESULTS: Among 485 enrolled participants, 293 (60%) were reassessed at 6 months and 163 (35%) at 12 months; 89 (51%) and 47 (27%) of the 173 participants initially managed with standard oxygen were reassessed at 6 and 12 months, respectively. At 3 months, 34%, 70% and 56% of the participants had a restrictive lung defect, impaired diffusing capacity of the lung for carbon monoxide ( ) and significant radiological sequelae, respectively. During extended follow-up, both and forced vital capacity percentage predicted increased by means of +4 points at 6 months and +6 points at 12 months. Sex, body mass index, chronic respiratory disease, immunosuppression, pneumonia extent or corticosteroid use during acute COVID-19 and prolonged invasive mechanical ventilation (IMV) were associated with at 3 months, but not its trajectory thereafter. Among 475 (98%) patients with at least one chest computed tomography scan during follow-up, 196 (41%) had significant sequelae on their last images.

CONCLUSIONS: Although pulmonary function and radiological abnormalities improved up to 1 year post-acute COVID-19, high percentages of severe-to-critical disease survivors, including a notable proportion of those managed with standard oxygen, had significant lung sequelae and residual symptoms justifying prolonged follow-up.

MeSH terms: Adult; Cohort Studies; COVID-19; Humans; Lung; Oxygen; Prospective Studies; Quality of Life; SARS-CoV-2
DOI: 10.1183/13993003.01532-2022