Persistent disabilities 28 months after COVID-19 hospitalisation, a prospective cohort study

Abstract

Background: Limited data are available on long-term respiratory disabilities in patients following acute COVID-19.

Patients and methods: This prospective, monocentric, observational cohort study included patients admitted to our hospital with acute COVID-19 between 12 March and 24 April 2020. Clinical, functional and radiological data were collected up to 28 months after hospital discharge.

Results: Among 715 patients hospitalised for COVID-19, 493 (69.0%) were discharged alive. We could access complete medical records for 268 out of 493 patients (54.4%); 138 out of 268 (51.5%) exhibited persistent respiratory symptoms and agreed with the data collection and follow-up. Patients were predominantly male (64.5%), with a mean±sd age of 58.9±15.3 years. At the last follow-up, the leading symptoms were asthenia (31.5%), dyspnoea (29.8%) and neuropsychological symptoms (17.7%). Lung function improved up to the last visit. Mean diffusing capacity of the lung for carbon monoxide (D _LCO) was 77.8% of predicted value, total lung capacity (TLC) was 83.5% and O₂ desaturation during exercise (O₂ desaturation) was 2.3%. While D _LCO improved over the entire period, TLC improved in the early phase and O₂ desaturation in the late phase. Except for those with lung comorbidities, only one patient presented with minor functional and chest radiological alterations at 28 months.

Conclusion: Patients with acute COVID-19 discharged alive showed improved clinical symptoms, lung function parameters and radiological signs up to 28 months post-infection. Persistent symptoms consisted mainly of asthenia and dyspnoea, with lung function returning to normal. One patient without prior respiratory issues exhibited moderate pulmonary fibrosis.

FIGURE 1

Flow chart of the study population. PFT: pulmonary function test.

FIGURE 2

Changes in a) total lung capacity (TLC), b) diffusion capacity of the lung for carbon monoxide, c) post-6-min walk test (6MWT) 5-class Borg scale and d) differences in pulse oxygen saturation during the 6MWT (post-6MWT minus pre-6MWT pulse oximetry) in the 27 patients followed up at 1, 3 and 28 months. The causes of missing values are given in the footnote to table 1.