RT Journal Article
SR Electronic
T1 Pulmonary function and radiological features 4 months after COVID-19: first results from the national prospective observational Swiss COVID-19 lung study
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 2003690
DO 10.1183/13993003.03690-2020
VO 57
IS 4
A1 Sabina A. Guler
A1 Lukas Ebner
A1 Catherine Aubry-Beigelman
A1 Pierre-Olivier Bridevaux
A1 Martin Brutsche
A1 Christian Clarenbach
A1 Christian Garzoni
A1 Thomas K. Geiser
A1 Alexandra Lenoir
A1 Marco Mancinetti
A1 Bruno Naccini
A1 Sebastian R. Ott
A1 Lise Piquilloud
A1 Maura Prella
A1 Yok-Ai Que
A1 Paula M. Soccal
A1 Christophe von Garnier
A1 Manuela Funke-Chambour
YR 2021
UL http://erj.ersjournals.com/content/57/4/2003690.abstract
AB Background The infectious coronavirus disease 2019 (COVID-19) pandemic is an ongoing global healthcare challenge. Up to one-third of hospitalised patients develop severe pulmonary complications and acute respiratory distress syndrome. Pulmonary outcomes following COVID-19 are unknown.Methods The Swiss COVID-19 lung study is a multicentre prospective cohort investigating pulmonary sequelae of COVID-19. We report on initial follow-up 4 months after mild/moderate or severe/critical COVID-19 according to the World Health Organization severity classification.Results 113 COVID-19 survivors were included (mild/moderate n=47, severe/critical n=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 of the lung for carbon monoxide (DLCO) % predicted, reduced 6-min walk distance (6MWD) and exercise-induced oxygen desaturation. After adjustment for potential confounding by age, sex and body mass index (BMI), patients after severe/critical COVID-19 had a DLCO 20.9% pred (95% CI 12.4–29.4% pred, p=0.01) lower at follow-up. DLCO % pred was the strongest independent factor associated with previous severe/critical disease when age, sex, BMI, 6MWD and minimal peripheral oxygen saturation at exercise were included in the multivariable model (adjusted odds ratio 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 4 months after severe acute respiratory syndrome coronavirus 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.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. https://bit.ly/34sNVvi