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. 2023 Jul-Aug;27(4):102789.
doi: 10.1016/j.bjid.2023.102789. Epub 2023 Jul 10.

Pulmonary function and exercise capacity six months after hospital discharge of patients with severe COVID-19

Jessica Polese  1 , Alessandro Demoner Ramos  2 , Isac Ribeiro Moulaz  3 , Larissa Sant'Ana  3 , Bárbara Sthefany de Paula Lacerda  3 , Cinthia Eduarda Santos Soares  3 , Karen Evelin Monlevade Lança  3 , Beatriz Paoli Thompson  3 , Germano Paulo Barbosa Júnior  3 , Isabella Izaita Polese Pinto  4 , José Geraldo Mill  5
Affiliations

Pulmonary function and exercise capacity six months after hospital discharge of patients with severe COVID-19

Jessica Polese et al. Braz J Infect Dis. 2023 Jul-Aug.

Abstract

Introduction: The long-term consequences of COVID-19, especially pulmonary impairment, are frequent but not well understood. The knowledge about sequels or long COVID-19 are necessary, considering the high prevalence and need for specific public strategies.

Method: The study was conducted to evaluate symptoms (standardized questionnaire), pulmonary function (spirometry), and exercise capacity (6-minute-walk-test) at 30 (D30), 90 (D90), and 180 (D180) days after hospital discharge of patients surviving to severe COVID-19. We excluded in this follow up patients with comorbidities before COVID infection.

Results: 44 patients were included and 31 (26 men) completed the 6-month follow-up (age mean 53.6 ± 9.6 years). At D180, 28% presented still at least one symptom. The most common was dyspnea (17.2%), followed by cough (13.8%), and myalgia (10.3%). All spirometric parameters showed progressive improvement from D30 to D180. However, 16% maintained a restrictive pattern on spirometry test, 44% presented desaturation on the 6-minute walk-test, and 25% walked < 75% of the predicted value.

Conclusion: 6-months after hospital discharge, reduced pulmonary function and reduced exercise capacity was founded frequently and more than a quarter remained symptomatic. The persistent symptoms and functional impairment suggest that sequels and development of Long COVID-19 are very common. The identification of these patients to provide the necessary health care is a challenging task, considering the large number of patients infected and surviving to COVID-19 disease.

Keywords: COVID-19; Pulmonary function test; SARS-COV-2; Symptoms.

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Conflict of interest statement

Conflicts of interest The authors declare no conflicts of interest.

Figures

Fig 1
Fig. 1
Patient selection flowchart. Flow diagram since the recruitment to inclusion.
Fig 2
Fig. 2
Boxplot of pulmonary function parameters at 30 (D30), 90 (D90) and 18 (D180) after hospital discharge of patients (n = 31) with severe COVID-19. Upper left: FVC, Forced Vital capacity; Upper right: FEV1, Forced Expiratory Volume in 1 second; Lower left: Nadir SpO2; Lower right: 6-MWD, 6-Minute Walked Distance. Each box indicates the median (horizontal line inside the box), Q1 (first quartile = lower hinge), Q3 (third quartile = upper hinge), and mean (x). The upper whisker extends from the hinge to the largest value no further than 1.5 * IQR from the hinge (IQR = inter-quartile range). The lower whisker extends from the hinge to the smallest value at most 1.5 * IQR of the hinge. Data beyond the end of the whiskers are plotted individually and defined as outliers, indicated as °. Statistically significant comparisons (p < 0.05) were represented by * over a link bar.
See this image and copyright information in PMC

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