Late Breaking Abstract - Persisting pulmonary impairment following severe SARS-CoV-2 infection, preliminary results from the CovILD study

Abstract

Background: In the 2002/2003 SARS1 outbreak, 30% of survivors exhibited persisting structural pulmonary abnormalities months after infection. Yet to this day, there is no follow-up data in patients after severe COVID-19.

Aims: In this prospective multicentre observational study, we aim to systematically evaluate the cardio-pulmonary damage in COVID-19 survivors at 6, 12, and 24 weeks after discharge.

Methods: At each visit, clinical examination, laboratory testing, blood gas analysis, lung function, thoracic HR-CT and echocardiography are conducted.

Results: Preliminary data from 82 consecutive patients was evaluated at the first follow-up visit, i.e. 6 weeks after discharge. Mean age was 56.7 years (63.4% males); 43.9% of patients had a positive smoking history. 54 patients (65.9%) exhibited persistent symptoms, with dyspnoea ranking highest (36.6%), followed by cough (19.5%). 20 patients (24.4%) showed persistent lung impairment (defined as FVC <80% and/or FEV1 <80%), while 31 patients (37.8%) showed signs of hyperinflation (defined as RV >120%). 23 patients (28%) showed reduced diffusion capacity (DLCO). 48 patients (58.5%) showed left ventricular diastolic dysfunction. Importantly, serum NT-proBNP, D-dimer, and ferritin levels were found significantly elevated.

Conclusion: A major portion of COVID-19 survivors presented with persisting dyspnoea and lung function abnormalities. Altogether, our results indicate prolonged resolution and remodelling, implementation of our HR-CT scan findings will finally be key to exactly define the cardio-pulmonary damage after COVID-19. We are eager to present our data of 6 and 12 weeks follow-ups at the ERS 2020.