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. 2023 Mar 13;23(1):84.
doi: 10.1186/s12890-023-02376-w.

Post-COVID dyspnea: prevalence, predictors, and outcomes in a longitudinal, prospective cohort

Japnam S Grewal  1 , Christopher Carlsten  1 , James C Johnston  1 , Aditi S Shah  1 , Alyson W Wong  1   2 , Christopher J Ryerson  3   4
Affiliations

Post-COVID dyspnea: prevalence, predictors, and outcomes in a longitudinal, prospective cohort

Japnam S Grewal et al. BMC Pulm Med. .

Abstract

Background: The pathophysiology, evolution, and associated outcomes of post-COVID dyspnea remain unknown. The aim of this study was to determine the prevalence, severity, and predictors of dyspnea 12 months following hospitalization for COVID-19, and to describe the respiratory, cardiac, and patient-reported outcomes in patients with post-COVID dyspnea.

Methods: We enrolled a prospective cohort of all adult patients admitted to 2 academic hospitals in Vancouver, Canada with PCR-confirmed SARS-CoV-2 during the first wave of COVID between March and June 2020. Dyspnea was measured 3, 6, and 12 months after initial symptom onset using the University of California San Diego Shortness of Breath Questionnaire.

Results: A total of 76 patients were included. Clinically meaningful dyspnea (baseline score > 10 points) was present in 49% of patients at 3 months and 46% at 12 months following COVID-19. Between 3 and 12 months post-COVID-19, 24% patients had a clinically meaningful worsening in their dyspnea, 49% had no meaningful change, and 28% had a clinically meaningful improvement in their dyspnea. There was worse sleep, mood, quality of life, and frailty in patients with clinically meaningful dyspnea at 12 months post-COVID infection compared to patients without dyspnea. There was no difference in PFT findings, troponin, or BNP comparing patients with and without clinically meaningful dyspnea at 12 months. Severity of dyspnea and depressive symptoms at 3 months predicted severity of dyspnea at 12 months.

Conclusions: Post-COVID dyspnea is common, persistent, and negatively impacts quality of life. Mood abnormalities may play a causative role in post-COVID dyspnea in addition to potential cardiorespiratory abnormalities. Dyspnea and depression at initial follow-up predict longer-term post-COVID dyspnea, emphasizing that standardized dyspnea and mood assessment following COVID-19 may identify patients at high risk of post-COVID dyspnea and facilitating early and effective management.

Keywords: COVID-19; Dyspnea; Outcomes; Patient; Predictors.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Study enrolment
Fig. 2
Fig. 2
Dyspnea over time following COVID-19. A clinically meaningful change in dyspnea was defined as a change in UCSD score equal to or greater than 5, based on the previously established MCID for the UCSD questionnaire. Change in dyspnea, as represented by the different colours of dots, is relative to the dyspnea score at 3 months post-COVID-19
Fig. 3
Fig. 3
Patient-reported, respiratory, and cardiac outcomes 12 months post-COVID-19 stratified by presence and absence of dyspnea. Abbreviations: FVC, forced vital capacity; FEV1, forced expiratory volume in the first second; TLC, total lung capacity; RV, residual volume; DLCO, diffusing capacity for carbon monoxide; BNP, B-type natriuretic peptide
Fig. 4
Fig. 4
Respiratory, cardiac, and psychological explanations for clinically significant dyspnea 12 months post-COVID-19. No patients had an isolated cardiac abnormality
See this image and copyright information in PMC

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