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ERJ Open Res
. 2023 Mar 13;9(2):00317-2022.
doi: 10.1183/23120541.00317-2022. eCollection 2023 Mar.
COVID-19 and its continuing burden after 12 months: a longitudinal observational prospective multicentre trial
Sabina Sahanic 1 , Piotr Tymoszuk 1 2 , Anna K Luger 3 , Katharina Hüfner 4 , Anna Boehm 1 , Alex Pizzini 1 , Christoph Schwabl 3 , Sabine Koppelstätter 1 , Katharina Kurz 1 , Malte Asshoff 1 , Birgit Mosheimer-Feistritzer 1 , Maximilian Coen 1 , Bernhard Pfeifer 5 , Verena Rass 6 , Alexander Egger 7 , Gregor Hörmann 7 , Barbara Sperner-Unterweger 4 , Raimund Helbok 6 , Ewald Wöll 8 , Günter Weiss 1 , Gerlig Widmann 3 , Ivan Tancevski 1 , Thomas Sonnweber 1 , Judith Löffler-Ragg 1
Affiliations
- PMID: 36960350
- PMCID: PMC10030059
- DOI: 10.1183/23120541.00317-2022
Abstract
Background: Recovery trajectories from coronavirus disease 2019 (COVID-19) call for longitudinal investigation. We aimed to characterise the kinetics and status of clinical, cardiopulmonary and mental health recovery up to 1 year following COVID-19.
Methods: Clinical evaluation, lung function testing (LFT), chest computed tomography (CT) and transthoracic echocardiography were conducted at 2, 3, 6 and 12 months after disease onset. Submaximal exercise capacity, mental health status and quality of life were assessed at 12 months. Recovery kinetics and patterns were investigated by mixed-effect logistic modelling, correlation and clustering analyses. Risk of persistent symptoms and cardiopulmonary abnormalities at the 1-year follow-up were modelled by logistic regression.
Findings: Out of 145 CovILD study participants, 108 (74.5%) completed the 1-year follow-up (median age 56.5 years; 59.3% male; 24% intensive care unit patients). Comorbidities were present in 75% (n=81). Key outcome measures plateaued after 180 days. At 12 months, persistent symptoms were found in 65% of participants; 33% suffered from LFT impairment; 51% showed CT abnormalities; and 63% had low-grade diastolic dysfunction. Main risk factors for cardiopulmonary impairment included pro-inflammatory and immunological biomarkers at early visits. In addition, we deciphered three recovery clusters separating almost complete recovery from patients with post-acute inflammatory profile and an enrichment in cardiopulmonary residuals from a female-dominated post-COVID-19 syndrome with reduced mental health status.
Conclusion: 1 year after COVID-19, the burden of persistent symptoms, impaired lung function, radiological abnormalities remains high in our study population. Yet, three recovery trajectories are emerging, ranging from almost complete recovery to post-COVID-19 syndrome with impaired mental health.