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Eur Respir J . Long-term Radiological and Pulmonary Function Abnormalities at 3-year post COVID-19 Hospitalization: A Longitudinal Cohort Study

tetano

Editor, Senior Moderator
Eur Respir J


. 2024 Feb 22:2301612.
doi: 10.1183/13993003.01612-2023. Online ahead of print. Long-term Radiological and Pulmonary Function Abnormalities at 3-year post COVID-19 Hospitalization: A Longitudinal Cohort Study

Xiaoyu Han[SUP] 1 2 3 [/SUP], Lu Chen[SUP] 4 3 [/SUP], Liyan Guo[SUP] 5 3 [/SUP], Linxia Wu[SUP] 1 2 3 [/SUP], Osamah Alwalid[SUP] 6 [/SUP], Jie Liu[SUP] 1 2 [/SUP], Yuting Zheng[SUP] 1 2 [/SUP], Leqing Chen[SUP] 1 2 [/SUP], Wenlong Wu[SUP] 1 2 [/SUP], Hanting Li[SUP] 1 2 [/SUP], Qinyue Luo[SUP] 1 2 [/SUP], Huangxuan Zhao[SUP] 1 2 [/SUP], Lijie Zhang[SUP] 1 2 [/SUP], Yaowei Bai[SUP] 1 2 [/SUP], Bo Sun[SUP] 1 2 [/SUP], Tao Sun[SUP] 1 2 [/SUP], Yuxi Gui[SUP] 1 2 [/SUP], Tong Nie[SUP] 1 2 [/SUP], Lei Chen[SUP] 1 2 [/SUP], Fan Yang[SUP] 1 2 7 [/SUP], Yanqing Fan[SUP] 4 7 [/SUP], Heshui Shi[SUP] 1 2 7 [/SUP], Chuansheng Zheng[SUP] 8 2 7 [/SUP]



Affiliations
Abstract

Background: This study aimed to evaluate the longitudinal progression of residual lung abnormalities (ground-glass opacities, reticulations, and fibrotic-like changes) and pulmonary function, three years following coronavirus disease 2019(COVID-19).
Methods: This prospective, longitudinal cohort study enrolled COVID-19 survivors who exhibited residual lung abnormalities upon discharge from two hospitals. Follow-up assessments were conducted at 6 months, 12 months, 2 years, and 3 years post-discharge, and included pulmonary function tests, 6-minute walk distance (6MWD), chest CT scans, and symptom questionnaires. Non-COVID-19 controls were retrospectively recruited for comparative analysis.
Results: 728 COVID-19 survivors and 792 controls were included. From 6 months to 3 years, there was a gradual improvement in reduced diffusing capacity of the lungs for carbon monoxide (DLCO<80% predicted, 49% versus 38%, p=0.001), 6MWD (496 m versus 510 m, p=0.002) and residual lung abnormalities(46% versus 36%, p<0.001), regardless of the disease severity. Patients with residual lung abnormalities at 3 years more commonly had respiratory symptoms (32% versus 16%, p<0.001), lower 6MWD (494 m versus 510 m, p=0.003), and abnormal DLCO (57% versus 27%, p<0.001) compared to those with complete resolution. Compared to the controls, the proportion of DLCO impairment (38% versus 17%, p<0.001) and respiratory symptoms (23% versus 2.2%, p<0.001) were significantly higher in the matched COVID-19 survivors at the 3-year follow-up.
Conclusions: Most patients exhibited improvement in radiological abnormalities and pulmonary function over time following COVID-19. However, more than one-third continued to have persistent lung abnormalities at the 3-year mark, which were associated with respiratory symptoms and reduced diffusion capacity.


 
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