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ERJ Open Res . Changes in pulmonary function and patient-reported outcomes during COVID-19 recovery: a longitudinal, prospective cohort study

tetano

Editor, Senior Moderator
ERJ Open Res


. 2021 Sep 13;7(3):00243-2021.
doi: 10.1183/23120541.00243-2021. eCollection 2021 Jul.
Changes in pulmonary function and patient-reported outcomes during COVID-19 recovery: a longitudinal, prospective cohort study


Aditi S Shah[SUP] 1 [/SUP], Min Hyung Ryu[SUP] 1 [/SUP], Cameron J Hague[SUP] 2 [/SUP], Darra T Murphy[SUP] 2 [/SUP], James C Johnston[SUP] 3 [/SUP], Christopher J Ryerson[SUP] 4 [/SUP], Christopher Carlsten[SUP] 1 5 [/SUP], Alyson W Wong[SUP] 4 5 [/SUP]



Affiliations

Abstract

Objectives: The aim of this study was to compare respiratory and patient-reported outcome measures (PROMs) between 3 and 6 months after symptom onset and to identify features that predict these changes.
Methods: This was a consecutive prospective cohort of 73 patients who were hospitalised with coronavirus disease 2019 (COVID-19). We evaluated the changes in pulmonary function tests and PROMs between 3 and 6 months and then investigated the associations between outcomes (change in diffusing capacity of the lung for carbon monoxide (D [SUB]LCO[/SUB]), dyspnoea and quality of life (QoL)) and clinical and radiological features.
Results: There was improvement in forced vital capacity, total lung capacity and D [SUB]LCO[/SUB] between 3 and 6 months by 3.25%, 3.82% and 5.69%, respectively; however, there was no difference in PROMs. Reticulation and total computed tomography (CT) scores were associated with lower D [SUB]LCO[/SUB] % predicted at 6 months (coefficients; -8.7 and -5.3, respectively). The association between radiological scores and D [SUB]LCO[/SUB] were modified by time, with the degree of association between ground glass and D [SUB]LCO[/SUB] having decreased markedly over time. There was no association between other predictors and change in dyspnoea or QoL over time.
Conclusions: There is improvement in pulmonary function measurements between 3 and 6 months after COVID-19 symptom onset; however, PROMs did not improve. A higher reticulation and total CT score are negatively associated with D [SUB]LCO[/SUB], but this association is attenuated over time. Lastly, there is a considerable proportion of patients with unexplained dyspnoea at 6 months, motivating further research to identify the underlying mechanisms.
 
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