Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2024 Jan;19(1):183-190.
doi: 10.1007/s11739-023-03400-x. Epub 2023 Sep 16.

Two-year cardio-pulmonary follow-up after severe COVID-19: a prospective study

Paola Faverio  1   2 , Giuseppe Paciocco  3   4 , Elena Tassistro  5 , Paola Rebora  5 , Emanuela Rossi  5 , Anna Monzani  3   4 , Marta Tundo  3   4 , Chiara Milano  3   4 , Martina Messa  3   4 , Raffaele Marocchi  3   4 , Alberto Pesci  3   4 , Giuseppe Foti  6 , Nicola Squillace  7 , Viola Cogliandro  7 , Maddalena Lettino  8 , Maria Grazia Strepparava  9 , Giuseppe Bellelli  10 , Carlo Ferrarese  11 , Maria Grazia Valsecchi  5 , Paolo Bonfanti  4   7 , Fabrizio Luppi  3   4 ; STORM Long-COVID Team
Collaborators, Affiliations
Observational Study

Two-year cardio-pulmonary follow-up after severe COVID-19: a prospective study

Paola Faverio et al. Intern Emerg Med. 2024 Jan.

Abstract

Short- and medium-term cardio-pulmonary sequelae after COVID-19 have been extensively studied. However, studies with longer follow-ups are required. This study aims to identify and characterise cardio-pulmonary sequelae, in patients hospitalised for SARS-CoV-2 pneumonia, at 24 months follow-up. This is a prospective, observational cohort study conducted on consecutive patients hospitalised for COVID-19 and acute respiratory failure. Patients were followed up at 24 months with complete pulmonary function tests (PFTs), 6-min walking test and a dyspnoea score (Modified Medical Research Council scale). A subgroup of patients with at least one clinical or functional sign suggestive of increased pulmonary pressures also underwent transthoracic echocardiography (TTE) to evaluate the presence of direct or indirect signs of pulmonary hypertension (PH). Ninety consecutive patients (74% men, median age 59.1 years) were enrolled in the study. In regard to PFTs, carbon monoxide diffusion capacity (DLCO) impairment was observed in 23 cases (26%), in all cases of mild entity. When considering the dyspnoea, 30 (34%) patients showed some degree of breathlessness. Forty patients underwent TTE. No patients had overt PH or chronic thromboembolic PH. However, all patients showed a hyperdynamic state of the right ventricle, and 8 (20%) patients had a decreased acceleration time on pulmonary valve, signs of increased pulmonary vasculature resistances and afterload elevation. At 24-month follow-up after severe COVID-19, DLCO and TTE prove to be the most sensitive tool to detect cardio-pulmonary sequelae. Dyspnoea is still present in about one-third of patients and requires a multidisciplinary approach.

Keywords: COVID-19; Pneumonia; Pulmonary circulation; Pulmonary hypertension; Respiratory function tests.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Alluvial plot describing the trend of dyspnoea evaluated through mMRC scale at 6-month, 12-month and 24-month follow-ups. mMRC modified medical research council. N = 81 patients who had mMRC evaluation at the three follow-up times
See this image and copyright information in PMC

Similar articles

  • One-year pulmonary impairment after severe COVID-19: a prospective, multicenter follow-up study.
    Faverio P, Luppi F, Rebora P, D'Andrea G, Stainer A, Busnelli S, Catalano M, Modafferi G, Franco G, Monzani A, Galimberti S, Scarpazza P, Oggionni E, Betti M, Oggionni T, De Giacomi F, Bini F, Bodini BD, Parati M, Bilucaglia L, Ceruti P, Modina D, Harari S, Caminati A, Intotero M, Sergio P, Monzillo G, Leati G, Borghesi A, Zompatori M, Corso R, Valsecchi MG, Bellani G, Foti G, Pesci A. Faverio P, et al. Respir Res. 2022 Mar 21;23(1):65. doi: 10.1186/s12931-022-01994-y. Respir Res. 2022. PMID: 35313890 Free PMC article.
  • Six-Month Pulmonary Impairment after Severe COVID-19: A Prospective, Multicentre Follow-Up Study.
    Faverio P, Luppi F, Rebora P, Busnelli S, Stainer A, Catalano M, Parachini L, Monzani A, Galimberti S, Bini F, Bodini BD, Betti M, De Giacomi F, Scarpazza P, Oggionni E, Scartabellati A, Bilucaglia L, Ceruti P, Modina D, Harari S, Caminati A, Valsecchi MG, Bellani G, Foti G, Pesci A. Faverio P, et al. Respiration. 2021;100(11):1078-1087. doi: 10.1159/000518141. Epub 2021 Aug 19. Respiration. 2021. PMID: 34515212 Free PMC article.
  • Respiratory and Psychophysical Sequelae Among Patients With COVID-19 Four Months After Hospital Discharge.
    Bellan M, Soddu D, Balbo PE, Baricich A, Zeppegno P, Avanzi GC, Baldon G, Bartolomei G, Battaglia M, Battistini S, Binda V, Borg M, Cantaluppi V, Castello LM, Clivati E, Cisari C, Costanzo M, Croce A, Cuneo D, De Benedittis C, De Vecchi S, Feggi A, Gai M, Gambaro E, Gattoni E, Gramaglia C, Grisafi L, Guerriero C, Hayden E, Jona A, Invernizzi M, Lorenzini L, Loreti L, Martelli M, Marzullo P, Matino E, Panero A, Parachini E, Patrucco F, Patti G, Pirovano A, Prosperini P, Quaglino R, Rigamonti C, Sainaghi PP, Vecchi C, Zecca E, Pirisi M. Bellan M, et al. JAMA Netw Open. 2021 Jan 4;4(1):e2036142. doi: 10.1001/jamanetworkopen.2020.36142. JAMA Netw Open. 2021. PMID: 33502487 Free PMC article.
  • [Follow-up of patients after COVID-19 pneumonia. Pulmonary sequelae].
    Chérrez-Ojeda I, Gochicoa-Rangel L, Salles-Rojas A, Mautong H. Chérrez-Ojeda I, et al. Rev Alerg Mex. 2020 Oct-Dec;67(4):350-369. doi: 10.29262/ram.v67i4.847. Rev Alerg Mex. 2020. PMID: 33631903 Review. Spanish.
  • [Morphological and functional sequelae after COVID-19 pneumonia].
    Milos RI, Kifjak D, Heidinger BH, Prayer F, Beer L, Röhrich S, Wassipaul C, Gompelmann D, Prosch H. Milos RI, et al. Radiologe. 2021 Oct;61(10):888-895. doi: 10.1007/s00117-021-00905-4. Epub 2021 Sep 16. Radiologe. 2021. PMID: 34529126 Free PMC article. Review. German.
See all similar articles

Cited by

References

    1. Lee JH, Yim JJ, et al. Pulmonary function and chest computed tomography abnormalities 6–12 months after recovery from COVID-19: a systematic review and meta-analysis. Respir Res. 2022;23(1):233. doi: 10.1186/s12931-022-02163-x. - DOI - PMC - PubMed
    1. Faverio P, Luppi F, et al. One-year pulmonary impairment after severe COVID-19: a prospective, multicenter follow-up study. Respir Res. 2022;23(1):65. doi: 10.1186/s12931-022-01994-y. - DOI - PMC - PubMed
    1. Scaramuzzo G, Ronzoni L, et al. Long-term dyspnea, regional ventilation distribution and peripheral lung function in COVID-19 survivors: a 1 year follow up study. BMC Pulm Med. 2022;22(1):408. doi: 10.1186/s12890-022-02214-5. - DOI - PMC - PubMed
    1. Wu X, Liu X, et al. 3-month, 6-month, 9-month, and 12-month respiratory outcomes in patients following COVID-19-related hospitalisation: a prospective study. Lancet Respir Med. 2021;9(7):747–754. doi: 10.1016/S2213-2600(21)00174-0. - DOI - PMC - PubMed
    1. Alkodaymi MS, Omrani OA, et al. Prevalence of post-acute COVID-19 syndrome symptoms at different follow-up periods: a systematic review and meta-analysis. Clin Microbiol Infect. 2022;28(5):657–666. doi: 10.1016/j.cmi.2022.01.014. - DOI - PMC - PubMed

Publication types