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

Autor: Guler SA; Dept of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Ebner L; Dept of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Aubry-Beigelman C; Radiodiagnostic and Interventional Radiology, CHUV-University Hospital, Lausanne, Switzerland., Bridevaux PO; Service de Pneumologie, Hôpital du Valais, Sion, Switzerland., Brutsche M; Lung Center, Kantonsspital St. Gallen, St. Gallen, Switzerland., Clarenbach C; Dept of Pneumology, University Hospital Zurich, Zurich, Switzerland., Garzoni C; Clinic of Internal Medicine and Infectious Diseases, Clinica Luganese Moncucco, Lugano, Switzerland.; Dept of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland., Geiser TK; Dept of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.; Dept for BioMedical Research, University of Bern, Bern, Switzerland., Lenoir A; Division of Pulmonary Medicine, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland., Mancinetti M; Dept of Internal Medicine, University and Hospital of Fribourg, Fribourg, Switzerland., Naccini B; Dept of Pulmonary Medicine, Clinica Luganese Moncucco, Lugano, Switzerland., Ott SR; Dept of Pulmonary Medicine, St. Claraspital AG, Basel, Switzerland., Piquilloud L; Adult Intensive Care Unit, University Hospital and University of Lausanne, Lausanne, Switzerland., Prella M; Division of Pulmonary Medicine, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland., Que YA; Dept of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Soccal PM; Division of Pulmonary Medicine, Geneva University Hospitals, Geneva, Switzerland., von Garnier C; Division of Pulmonary Medicine, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland., Funke-Chambour M; Dept of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.; Dept for BioMedical Research, University of Bern, Bern, Switzerland.
Jazyk: angličtina
Zdroj: The European respiratory journal [Eur Respir J] 2021 Apr 29; Vol. 57 (4). Date of Electronic Publication: 2021 Apr 29 (Print Publication: 2021).
DOI: 10.1183/13993003.03690-2020
Abstrakt: 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, i.e. diffusing capacity of the lung for carbon monoxide ( D LCO ) % 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 D LCO 20.9% pred (95% CI 12.4-29.4% pred, p=0.01) lower at follow-up. D LCO % 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.
Competing Interests: Conflict of interest: S.A. Guler has nothing to disclose. Conflict of interest: L. Ebner has nothing to disclose. Conflict of interest: C. Beigelman reports personal fees for lectures from AstraZeneca and Boehringer, outside the submitted work. Conflict of interest: P-O. Bridevaux has nothing to disclose. Conflict of interest: M. Brutsche has nothing to disclose. Conflict of interest: C. Clarenbach reports personal fees from Roche, Novartis, Boehringer, GSK, AstraZeneca, Sanofi, Vifor and Mundipharma, outside the submitted work. Conflict of interest: C. Garzoni has nothing to disclose. Conflict of interest: T.K. Geiser has nothing to disclose. Conflict of interest: A. Lenoir has nothing to disclose. Conflict of interest: M. Mancinetti has nothing to disclose. Conflict of interest: B. Naccini has nothing to disclose. Conflict of interest: S.R. Ott has nothing to disclose. Conflict of interest: L. Piquilloud has nothing to disclose. Conflict of interest: M. Prella has nothing to disclose. Conflict of interest: Y-A. Que has nothing to disclose. Conflict of interest: P.M. Soccal has nothing to disclose. Conflict of interest: C. von Garnier has nothing to disclose. Conflict of interest: M. Funke-Chambour has nothing to disclose.
(Copyright ©ERS 2021.)
Databáze: MEDLINE
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