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Objectives  The aim of this study was to compare respiratory and patient-reported outcome measures (PROMs) between 3 and 6 months after symptom onset and to identify features that predict these changes.    Methods  This was a consecutive prospective cohort of 73 patients who were hospitalised with coronavirus disease 2019 (COVID-19). We evaluated the changes in pulmonary function tests and PROMs between 3 and 6 months and then investigated the associations between outcomes (change in diffusing capacity of the lung for carbon monoxide ( D  LCO ), dyspnoea and quality of life (QoL)) and clinical and radiological features.    Results  There was improvement in forced vital capacity, total lung capacity and  D  LCO  between 3 and 6 months by 3.25%, 3.82% and 5.69%, respectively; however, there was no difference in PROMs. Reticulation and total computed tomography (CT) scores were associated with lower  D  LCO  % predicted at 6 months (coefficients; −8.7 and −5.3, respectively). The association between radiological scores and  D  LCO  were modified by time, with the degree of association between ground glass and  D  LCO  having decreased markedly over time. There was no association between other predictors and change in dyspnoea or QoL over time.    Conclusions  There is improvement in pulmonary function measurements between 3 and 6 months after COVID-19 symptom onset; however, PROMs did not improve. A higher reticulation and total CT score are negatively associated with  D  LCO , but this association is attenuated over time. Lastly, there is a considerable proportion of patients with unexplained dyspnoea at 6 months, motivating further research to identify the underlying mechanisms.

Changes in pulmonary function and patient-reported outcomes during COVID-19 recovery: a longitudinal, prospective cohort study