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ERJ Open Res . COVID-19 and its continuing burden after 12 months: a longitudinal observational prospective multicentre trial

tetano

Editor, Senior Moderator
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[SUP] 1 [/SUP], Piotr Tymoszuk[SUP] 1 2 [/SUP], Anna K Luger[SUP] 3 [/SUP], Katharina Hüfner[SUP] 4 [/SUP], Anna Boehm[SUP] 1 [/SUP], Alex Pizzini[SUP] 1 [/SUP], Christoph Schwabl[SUP] 3 [/SUP], Sabine Koppelstätter[SUP] 1 [/SUP], Katharina Kurz[SUP] 1 [/SUP], Malte Asshoff[SUP] 1 [/SUP], Birgit Mosheimer-Feistritzer[SUP] 1 [/SUP], Maximilian Coen[SUP] 1 [/SUP], Bernhard Pfeifer[SUP] 5 [/SUP], Verena Rass[SUP] 6 [/SUP], Alexander Egger[SUP] 7 [/SUP], Gregor Hörmann[SUP] 7 [/SUP], Barbara Sperner-Unterweger[SUP] 4 [/SUP], Raimund Helbok[SUP] 6 [/SUP], Ewald Wöll[SUP] 8 [/SUP], Günter Weiss[SUP] 1 [/SUP], Gerlig Widmann[SUP] 3 [/SUP], Ivan Tancevski[SUP] 1 [/SUP], Thomas Sonnweber[SUP] 1 [/SUP], Judith Löffler-Ragg[SUP] 1 [/SUP]



Affiliations

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.
 
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