tetano
Editor, Senior Moderator
Eur Respir J
. 2021 Jan 8;2003690.
doi: 10.1183/13993003.03690-2020. Online ahead of print.
Pulmonary function and radiological features four months after COVID-19: first results from the national prospective observational Swiss COVID-19 lung study
Sabina A Guler[SUP] 1 [/SUP], Lukas Ebner[SUP] 2 [/SUP], Catherine Beigelman[SUP] 3 [/SUP], Pierre-Olivier Bridevaux[SUP] 4 [/SUP], Martin Brutsche[SUP] 5 [/SUP], Christian Clarenbach[SUP] 6 [/SUP], Christian Garzoni[SUP] 7 8 [/SUP], Thomas K Geiser[SUP] 1 9 [/SUP], Alexandra Lenoir[SUP] 10 [/SUP], Marco Mancinetti[SUP] 11 [/SUP], Bruno Naccini[SUP] 12 [/SUP], Sebastian R Ott[SUP] 13 [/SUP], Lise Piquilloud[SUP] 14 [/SUP], Maura Prella[SUP] 10 [/SUP], Yok-Ai Que[SUP] 15 [/SUP], Paula M Soccal[SUP] 16 [/SUP], Christophe von Garnier[SUP] 10 [/SUP], Manuela Funke-Chambour[SUP] 1 9 [/SUP]
Affiliations
Abstract
Background: The coronavirus infectious disease (COVID-19) pandemic is an ongoing global health care challenge. Up to one third of hospitalised patients develop severe pulmonary complications and ARDS. Pulmonary outcomes following COVID-19 are unknown.
Methods: The Swiss COVID-19 lung study is a multicentre prospective cohort investigating pulmonary sequela of COVID-19. We report on initial follow-up 4 months after mild/moderate or severe/critical COVID-19 according to the WHO severity classification.
Results: 113 COVID-19 survivors were included (mild/moderate 47, severe/critical 66). We confirmed several comorbidities as risk factors for severe/critical disease. Severe/critical disease was associated with impaired pulmonary function, i.e. diffusing capacity (DLCO) %-predicted, reduced 6-MWD, and exercise-induced oxygen desaturation. After adjustment for potential confounding by age, sex, and BMI, patients after severe/critical COVID-19 had a 20.9 (95% CI 12.4-29.4, p=0.01) lower DLCO %-predicted at follow up. DLCO %-predicted was the strongest independent factor associated with previous severe/critical disease when age, sex, BMI, 6MWD, and minimal SpO[SUB]2[/SUB] at exercise, were included in the multivariable model (adjusted odds ratio [OR] per 10%-predicted 0.59 [95% CI 0. 37-0.87], p=0.01). Mosaic hypoattenuation on chest computed tomography at follow-up was significantly associated with previous severe/critical COVID-19 including adjustment for age and sex (adjusted OR 11.7 [95%CI 1.7-239), p=0.03).
Conclusions: Four months after SARS CoV-2 infection, severe/critical COVID-19 was associated with significant functional and radiological abnormalities, potentially due to small airway and lung parenchymal disease. A systematic follow-up for survivors needs to be evaluated to optimise care for patients recovering from COVID-19.
. 2021 Jan 8;2003690.
doi: 10.1183/13993003.03690-2020. Online ahead of print.
Pulmonary function and radiological features four months after COVID-19: first results from the national prospective observational Swiss COVID-19 lung study
Sabina A Guler[SUP] 1 [/SUP], Lukas Ebner[SUP] 2 [/SUP], Catherine Beigelman[SUP] 3 [/SUP], Pierre-Olivier Bridevaux[SUP] 4 [/SUP], Martin Brutsche[SUP] 5 [/SUP], Christian Clarenbach[SUP] 6 [/SUP], Christian Garzoni[SUP] 7 8 [/SUP], Thomas K Geiser[SUP] 1 9 [/SUP], Alexandra Lenoir[SUP] 10 [/SUP], Marco Mancinetti[SUP] 11 [/SUP], Bruno Naccini[SUP] 12 [/SUP], Sebastian R Ott[SUP] 13 [/SUP], Lise Piquilloud[SUP] 14 [/SUP], Maura Prella[SUP] 10 [/SUP], Yok-Ai Que[SUP] 15 [/SUP], Paula M Soccal[SUP] 16 [/SUP], Christophe von Garnier[SUP] 10 [/SUP], Manuela Funke-Chambour[SUP] 1 9 [/SUP]
Affiliations
- PMID: 33419891
- DOI: 10.1183/13993003.03690-2020
Abstract
Background: The coronavirus infectious disease (COVID-19) pandemic is an ongoing global health care challenge. Up to one third of hospitalised patients develop severe pulmonary complications and ARDS. Pulmonary outcomes following COVID-19 are unknown.
Methods: The Swiss COVID-19 lung study is a multicentre prospective cohort investigating pulmonary sequela of COVID-19. We report on initial follow-up 4 months after mild/moderate or severe/critical COVID-19 according to the WHO severity classification.
Results: 113 COVID-19 survivors were included (mild/moderate 47, severe/critical 66). We confirmed several comorbidities as risk factors for severe/critical disease. Severe/critical disease was associated with impaired pulmonary function, i.e. diffusing capacity (DLCO) %-predicted, reduced 6-MWD, and exercise-induced oxygen desaturation. After adjustment for potential confounding by age, sex, and BMI, patients after severe/critical COVID-19 had a 20.9 (95% CI 12.4-29.4, p=0.01) lower DLCO %-predicted at follow up. DLCO %-predicted was the strongest independent factor associated with previous severe/critical disease when age, sex, BMI, 6MWD, and minimal SpO[SUB]2[/SUB] at exercise, were included in the multivariable model (adjusted odds ratio [OR] per 10%-predicted 0.59 [95% CI 0. 37-0.87], p=0.01). Mosaic hypoattenuation on chest computed tomography at follow-up was significantly associated with previous severe/critical COVID-19 including adjustment for age and sex (adjusted OR 11.7 [95%CI 1.7-239), p=0.03).
Conclusions: Four months after SARS CoV-2 infection, severe/critical COVID-19 was associated with significant functional and radiological abnormalities, potentially due to small airway and lung parenchymal disease. A systematic follow-up for survivors needs to be evaluated to optimise care for patients recovering from COVID-19.