Pulmonary function and radiological features 4 months after COVID-19: first results from the national prospective observational Swiss COVID-19 lung study

Publication

Pulmonary function and radiological features 4 months after COVID-19: first results from the national prospective observational Swiss COVID-19 lung study

Journal Paper/Review - Apr 29, 2021

Guler Sabina A, von Garnier Christophe, Soccal Paula M, Que Yok-Ai, Prella Maura, Piquilloud Lise, Ott Sebastian R, Naccini Bruno, Mancinetti Marco, Lenoir Alexandra, Geiser Thomas K, Garzoni Christian, Clarenbach Christian, Brutsche Martin, Bridevaux Pierre-Olivier, Aubry-Beigelman Catherine, Ebner Lukas, Funke-Chambour Manuela

Citation

Guler S, von Garnier C, Soccal P, Que Y, Prella M, Piquilloud L, Ott S, Naccini B, Mancinetti M, Lenoir A, Geiser T, Garzoni C, Clarenbach C, Brutsche M, Bridevaux P, Aubry-Beigelman C, Ebner L, Funke-Chambour M. Pulmonary function and radiological features 4 months after COVID-19: first results from the national prospective observational Swiss COVID-19 lung study. Eur Respir J. 2021; 57

Type

Journal Paper/Review (English)

Journal

Eur Respir J. 2021; 57

Publication Date

Apr 29, 2021

Issn Electronic

1399-3003

Brief description/objective

BACKGROUND
The infectious coronavirus disease 2019 (COVID-19) pandemic is an ongoing global healthcare challenge. Up to one-third of hospitalised patients develop severe pulmonary complications and acute respiratory distress syndrome. Pulmonary outcomes following COVID-19 are unknown.

METHODS
The Swiss COVID-19 lung study is a multicentre prospective cohort investigating pulmonary sequelae of COVID-19. We report on initial follow-up 4 months after mild/moderate or severe/critical COVID-19 according to the World Health Organization severity classification.

RESULTS
113 COVID-19 survivors were included (mild/moderate n=47, severe/critical n=66). We confirmed several comorbidities as risk factors for severe/critical disease. Severe/critical disease was associated with impaired pulmonary function, diffusing capacity of the lung for carbon monoxide ( ) % predicted, reduced 6-min walk distance (6MWD) and exercise-induced oxygen desaturation. After adjustment for potential confounding by age, sex and body mass index (BMI), patients after severe/critical COVID-19 had a 20.9% pred (95% CI 12.4-29.4% pred, p=0.01) lower at follow-up. % pred was the strongest independent factor associated with previous severe/critical disease when age, sex, BMI, 6MWD and minimal peripheral oxygen saturation at exercise were included in the multivariable model (adjusted odds ratio per 10% predicted 0.59, 95% CI 0. 37-0.87; p=0.01). Mosaic hypoattenuation on chest computed tomography at follow-up was significantly associated with previous severe/critical COVID-19 including adjustment for age and sex (adjusted OR 11.7, 95% CI 1.7-239; p=0.03).

CONCLUSIONS
4 months after severe acute respiratory syndrome coronavirus 2 infection, severe/critical COVID-19 was associated with significant functional and radiological abnormalities, potentially due to small-airway and lung parenchymal disease. A systematic follow-up for survivors needs to be evaluated to optimise care for patients recovering from COVID-19.