Open AccessSpontaneous Evolution of COVID-19 Lung Sequelae: Results from a Double-Step Follow-Up
Author(s) -
Martina Ferioli,
Irene Prediletto,
Serena Bensai,
Sara Betti,
Federico Daniele,
Valerio Di Scioscio,
Cecilia Modolon,
Maria Rita Rimondi,
Chiara De Molo,
Carla Serra,
Stefano Nava,
Luca Fasano
Publication year - 2022
Publication title -
respiration
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.264
H-Index - 81
eISSN - 1423-0356
pISSN - 0025-7931
DOI - 10.1159/000521316
Subject(s) - medicine , dlco , spirometry , lung , cardiology , diffusing capacity , lung function , asthma
Background: Few studies have reported a double-step follow-up of patients after hospitalization for COVID-19. Objectives: We designed an observational double-step follow-up study with a clinical, functional, and radiological evaluation at 2 and 6 months after COVID-19. The primary outcome was to describe symptoms, spirometry, and 6-minute walking test (6MWT) at 2 and 6 months. Secondary outcomes were to identify if the lowest PaO 2 /FiO 2 during hospitalization is related with functional and radiological evolution and to assess the correlation between radiological and functional abnormalities at 6 months. Methods: Symptoms, spirometry, and 6MWT were assessed at 2 and 6 months; arterial blood gas, chest x-ray, and lung ultrasound were performed at 2 months; body plethysmography, diffusing capacity for carbon monoxide (DLCO), and CT scan were performed at 6 months. Results: Sixty-four per cent and 42% of patients reported at least one symptom at 2 and 6 months, respectively. The most common 6-month functional alteration was DLCO impairment (57% of patients). An improvement of FEV1, FVC, and 6MWT was observed between 2 and 6 months ( p < 0.001). Patients with PaO 2 /FiO 2 <200 during hospitalization performed worse at 6MWT at 2 and 6 months ( p < 0.05) and reported more extended radiological abnormalities at 6 months ( p < 0.001) compared with patients with PaO 2 /FiO 2 >200. At 6 months, more extended radiological abnormalities were related with worse 6MWT, DLCO, and total lung capacity ( p < 0.05). Discussion: DLCO and 6MWT impairment seem to be the functional hallmark of COVID-19 and are related with the severity of acute pneumonia. At 6 months, radiological abnormalities were related to functional impairment.