Respiratory recovery trajectories after severe-to-critical COVID-19: a 1-year prospective multicentre study.
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Schlemmer Frédéric, Valentin Simon, Boyer Laurent, Guillaumot Anne, Chabot François, Dupin Clairelyne, Le Guen Pierre, Lorillon Gwenael, Bergeron Anne, Basille Damien, Delomez Julia, Andrejak Claire, Bonnefoy Valentine, Goussault Hélène, Assié Jean-Baptiste, Choinier Pascaline, Ruppert Anne-Marie, Cadranel Jacques, Mennitti Maria Chiara, Roumila Mehdi, Colin Charlotte, Günther Sven, Sanchez Olivier, Gille Thomas, Sésé Lucile, Uzunhan Yurdagul, Faure Morgane, Patout Maxime, Morelot-Panzini Capucine, Laveneziana Pierantonio, Zysman Maeva, Blanchard Elodie, Raherison-Semjen Chantal, Giraud Violaine, Giroux-Leprieur Etienne, Habib Stéfanie, Roche Nicolas, Dinh-Xuan Anh Tuan, Sifaoui Islem, Brillet Pierre-Yves, Jung Camille, Boutin Emmanuelle, Layese Richard, Canoui-Poitrine Florence, Maitre Bernard, RE2COVERI Study Group
Аннотация
METHODS: Adults hospitalised for severe-to-critical COVID-19 were evaluated at 3 months and up to 12 months post-hospital discharge in this prospective, multicentre, cohort study.
RESULTS: Among 485 enrolled participants, 293 (60%) were reassessed at 6 months and 163 (35%) at 12 months; 89 (51%) and 47 (27%) of the 173 participants initially managed with standard oxygen were reassessed at 6 and 12 months, respectively. At 3 months, 34%, 70% and 56% of the participants had a restrictive lung defect, impaired diffusing capacity of the lung for carbon monoxide (D LCO) and significant radiological sequelae, respectively. During extended follow-up, both D LCO and forced vital capacity percentage predicted increased by means of +4 points at 6 months and +6 points at 12 months. Sex, body mass index, chronic respiratory disease, immunosuppression, pneumonia extent or corticosteroid use during acute COVID-19 and prolonged invasive mechanical ventilation (IMV) were associated with D LCO at 3 months, but not its trajectory thereafter. Among 475 (98%) patients with at least one chest computed tomography scan during follow-up, 196 (41%) had significant sequelae on their last images.
CONCLUSIONS: Although pulmonary function and radiological abnormalities improved up to 1 year post-acute COVID-19, high percentages of severe-to-critical disease survivors, including a notable proportion of those managed with standard oxygen, had significant lung sequelae and residual symptoms justifying prolonged follow-up.