1-year radiological, functional and quality-of-life outcomes in patients with SARS-CoV-2 pneumonia - A prospective observational study

Abstract

All over the world, SARS-CoV-2 pneumonia is causing a significant short and medium-term morbidity and mortality, with reported persisting symptoms, radiological and lung alterations up to 6 months after symptoms onset. Nevertheless, the 1-year impact on affected patients is still poorly known. In this prospective observational study, 39 patients with SARS-CoV-2 pneumonia were recruited from a single COVID-19 hospital in Southern Switzerland. They underwent a 3-month and 1-year follow-ups. At 1 year, 38 patients underwent functional follow-up through lung function tests and six minutes walking test and submitted SF-12 and SGRQ questionnaires about health-related quality of life. At 1 year most of the patients showed a persistence of the radiological and functional abnormalities and a reduction of the health-related quality of life. Thirty patients (96.8%) still presented some residual abnormalities on CT scans (31 patients at 3 months), though with a general reduction of the lesional load in all lung lobes. Twenty patients (52.6%) had persisting lung function tests impairment, with an overall improvement of DLCO. As concerning the functional status, lowest SpO2 during 6MWT increased significantly. Finally, 19 patients (50%) reported a pathological St. George's Respiratory Questionnaire, and respectively 12 (31.6%) and 11 (28.9%) patients a pathological Short Form Survey-12 in physical and mental components. At 1-year follow-up SARS-CoV-2 pneumonia survivors still present a substantial impairment in radiological and functional findings and in health-related quality of life, despite showing a progressive recovery.

Fig. 1. Study timeline.

We represent the study timeline, with the 3 phases (admission, 3-month f-up and 1-year f-up) and the exams performed in each phase.

Fig. 2. Typical SARS-CoV-2 CT scan lesions and their evolution at 3 and 12 months.

Asterisks show complete healing of the areas of consolidation at 3 months. White arrows demonstrate a slower but almost complete resolution of the areas of ground glass opacities at 3 and 12 months.

Fig. 3. Comparison of lung function tests, 6 min walk test, lowest SpO2 during 6MWT and health-related quality of life questionnaires (SGRQ and SF-12) at 3- and 12-month follow-ups.

Each variable was represented as mean ± SD or median and 25^th–75^th percentile as appropriate.