Abstract
Background The coronavirus infectious disease (COVID-19) pandemic is an ongoing global health care challenge. Up to one third of hospitalised patients develop severe pulmonary complications and ARDS. Pulmonary outcomes following COVID-19 are unknown.
Methods The Swiss COVID-19 lung study is a multicentre prospective cohort investigating pulmonary sequela of COVID-19. We report on initial follow-up 4 months after mild/moderate or severe/critical COVID-19 according to the WHO severity classification.
Results 113 COVID-19 survivors were included (mild/moderate 47, severe/critical 66). We confirmed several comorbidities as risk factors for severe/critical disease. Severe/critical disease was associated with impaired pulmonary function, i.e. diffusing capacity (DLCO) %-predicted, reduced 6-MWD, and exercise-induced oxygen desaturation. After adjustment for potential confounding by age, sex, and BMI, patients after severe/critical COVID-19 had a 20.9 (95% CI 12.4–29.4, p=0.01) lower DLCO %-predicted at follow up. DLCO %-predicted was the strongest independent factor associated with previous severe/critical disease when age, sex, BMI, 6MWD, and minimal SpO2 at exercise, were included in the multivariable model (adjusted odds ratio [OR] per 10%-predicted 0.59 [95% CI 0. 37–0.87], p=0.01). Mosaic hypoattenuation on chest computed tomography at follow-up was significantly associated with previous severe/critical COVID-19 including adjustment for age and sex (adjusted OR 11.7 [95%CI 1.7–239), p=0.03).
Conclusions Four months after SARS CoV-2 infection, severe/critical COVID-19 was associated with significant functional and radiological abnormalities, potentially due to small airway and lung parenchymal disease. A systematic follow-up for survivors needs to be evaluated to optimise care for patients recovering from COVID-19.
Abstract
COVID-19 pulmonary sequelae are unknown. The Swiss COVID-19 lung study reports on initial follow-up findings. Severe or critical COVID-19 was associated with significant functional impairment and radiological abnormalities after 4 months.
Footnotes
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Data availability: Data are available upon request and after approval of teh steering committee of the Swiss COVID-19 lung study group.
Support statement: Lungenliga Bern, Johanna Dürmüller Foundation, Bern Center for Precision Medicine (BCPM) and the Department für Lehre und Forschung (DLF) of the Inselspital Bern funded parts of this study but had no role in the conduct of the conduct of the investigation. Department for Research and Education, Inselspital (DLF); Bern Center for Precision Medicine; Johanna Dürmüller Foundation; Lungenliga Bern.
Conflict of interest: Dr. Guler has nothing to disclose.
Conflict of interest: Dr. Ebner has nothing to disclose.
Conflict of interest: Dr. Beigelman-Aubry reports personal fees from Astra Zeneca, personal fees from Boehringer, outside the submitted work;.
Conflict of interest: Dr. Bridevaux has nothing to disclose.
Conflict of interest: Dr. BRUTSCHE has nothing to disclose.
Conflict of interest: Dr. Clarenbach reports personal fees from Roche, personal fees from Novartis, personal fees from Boehringer, personal fees from GSK, personal fees from Astra Zeneca, personal fees from Sanofi, personal fees from Vifor, personal fees from Mundipharma, outside the submitted work;.
Conflict of interest: Dr. Garzoni has nothing to disclose.
Conflict of interest: TG has nothing to disclose.
Conflict of interest: Dr. Lenoir has nothing to disclose.
Conflict of interest: Dr. Mancinetti has nothing to disclose.
Conflict of interest: Dr.B.Naccini has nothing to disclose.
Conflict of interest: Dr. Ott has nothing to disclose.
Conflict of interest: Dr. Piquilloud has nothing to disclose.
Conflict of interest: Dr Prella has nothing to disclose.
Conflict of interest: Dr. QUE has nothing to disclose.
Conflict of interest: Dr. Soccal has nothing to disclose.
Conflict of interest: Dr. von Garnier has nothing to disclose.
Conflict of interest: Dr. Funke-Chambour has nothing to disclose.
- Received September 30, 2020.
- Accepted December 13, 2020.
- Copyright ©ERS 2021
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