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Open Forum Infect Dis . Long-term Outcomes and Recovery of Patients who Survived COVID-19: LUNG INJURY COVID-19 Study

tetano

Editor, Senior Moderator
Open Forum Infect Dis


. 2022 Feb 25;9(4):ofac098.
doi: 10.1093/ofid/ofac098. eCollection 2022 Apr.
Long-term Outcomes and Recovery of Patients who Survived COVID-19: LUNG INJURY COVID-19 Study


Gianna Vargas Centanaro[SUP] 1 2 [/SUP], Myriam Calle Rubio[SUP] 1 2 3 [/SUP], José Luis Álvarez-Sala Walther[SUP] 1 2 [/SUP], Fernando Martinez-Sagasti[SUP] 4 [/SUP], Andrea Albuja Hidalgo[SUP] 1 [/SUP], Rafael Herranz Hernández[SUP] 5 [/SUP], Juan Luis Rodríguez Hermosa[SUP] 1 2 3 [/SUP]



Affiliations

Abstract

Background: LUNG INJURY COVID-19 (clinicaltrials.gov NCT 21/399-E) is a registry-based prospective observational cohort study to evaluate long-term outcomes and recovery 12 months after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection according to severity.
Methods: Three hundred five coronavirus disease 2019 (COVID-19) survivors were included (moderate, 162; severe, 143). Twelve months after SARS-CoV-2 infection, there was resolution of respiratory symptoms (37.9% in severe vs 27.3% in moderate pneumonia; P = .089).
Results: Exertional dyspnea was present (20% in severe vs 18.4% in moderate; P = .810). Abnormalities on chest radiology imaging were detected more often in severe COVID-19 infection vs moderate infection (29% vs 8.8%; P < .001). Pulmonary function testing (forced spirometry or diffusion) performed at 12 months of mean follow-up according to protocol detected anomalies in 31.4% of patients with severe COVID-19 courses and in 27.7% of moderate patients. Risk factors associated with diffusion impairment at 12 months were age (odds ratio [OR], 1.05; 95% CI, 1.01-1.10; P = .008), forced expiratory volume in 1 second predicted at follow-up (OR, 0.96; 95% CI, 0.93-0.99; P = .017), and dyspnea score at follow-up (OR, 3.16; 95% CI, 1.43-6.97; P = .004). Computed tomography (CT) scans performed at 12 months of mean follow-up showed evidence of fibrosis in almost half of patients with severe COVID-19 courses, who underwent CT according to protocol.
Conclusions: At 12 months from infection onset, most patients refer to symptoms, particularly muscle weakness and dyspnea, and almost one-third of patients with severe COVID-19 pneumonia had impaired pulmonary diffusion and abnormalities on chest radiology imaging. These results emphasize the importance of systematic follow-up after severe COVID-19, with appropriate management of pulmonary sequelae.

Keywords: SARS-CoV-2 infection; long-term effects; sequelae.
 
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