Pulmonary impairment persists during first 6 months post-COVID-19 hospitalization

A new study reported persistent pulmonary impairment, symptoms and reduced health-related quality of life during the first 6 months following COVID-19 hospitalization, but gradual improvements were seen over time.

“Our findings are in line with reports from other groups and reports of long COVID, even in patients who were mildly ill, although it seems to occur more frequently in hospitalized patients. The exact causes and prevalence of residual symptoms and long COVID remain a topic of worldwide study,” Merel E. Hellemons, MD, from the department of respiratory medicine at Erasmus Medical Center at the University Medical Center Rotterdam, Rotterdam, the Netherlands, told Healio.

Hellemons and colleagues aimed to evaluate the sequelae up to 6 months following hospitalization for COVID-19, focusing on the recovery of pulmonary function and radiological abnormalities, as well as physical and mental health status, and overall health-related quality of life.

This study included 92 patients (mean age, 58.2 years; 63% men) who were hospitalized with COVID-19 from February to July 2020. All patients had evaluations including pulmonary function testing, radiological evaluation, and online questionnaires regarding physical status, mental health status and health-related quality of life at 6 weeks, 3 months and 6-months following hospitalization.

Researchers observed an improvement in the percentage of patients with impaired FVC, from 25% at 6 weeks to 21% at 3 months to 11% at 6 months, according to the results. The percentage of patients with impaired diffusion capacity also improved over time, from 63% at 6 weeks to 51% at 3 months to 46% at 6 months, according to the results.

Hellemons and colleagues also reported decreases in radiologic ground glass opacities (32 patients at 3 months; 27 patients at 6 months; P = .126), but pulmonary fibrosis persisted, they wrote .

Eighty-nine percent of patients reported at least one persistent symptom of COVID-19 at 6 months after discharge. Reports of fatigue significantly decreased over time (P = .006). However, researchers noted that fatigue was still present among 51% of patients at 6 months.

In other results, the researchers reported that most domains of health-related quality of life were improved at 6 months, excluding physical role functioning.

Longer time since hospitalization (P < .001) and longer hospital length of stay (P = .007) were independent predictors of lower diffusing capacity of the lungs for carbon monoxide percent predicted in multivariable analyses. Hospital length of stay (P = .007) and persistent fatigue (P < .001) were independent predictors of lower role functioning scores.

“Many questions remain on recovery after COVID-19,” Hellemons told Healio. Such questions focus on the trajectory of physical recovery; how residual symptoms develop and whether they reside over time; risk factors and causes of residual symptoms; and how recovery after COVID-19 differs from recovery after other respiratory diseases, she said.

Hellemons said the researchers will continue to study these questions in the larger, multicenter, prospective COFLOW study, which will follow more than 650 patients for up to 2 years following COVID-19 hospitalization.

For more information:

Merel E. Hellemons, MD, can be reached at m.hellemons@erasmusmc.nl.