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Recovery after admission with COVID-19 pneumonia – A follow-up study - 06/06/23

Doi : 10.1016/j.resmer.2023.101001 
Simone van der Sar-van der Brugge a, , Antine Flikweert a, 1, Arthur du Mee b, 1, Kim Gense d, Sander Talman a, Merijn Kant a, c, Ingrid De Backer a
a Amphia Hospital, Department of Pulmonary Medicine, Postbus 90158, 4800 RK Breda, the Netherlands 
b Amphia Hospital, Department of Radiology, Postbus 90158, 4800 RK Breda, the Netherlands 
c Amphia Hospital, Department of Intensive Care Medicine, Postbus 90158, 4800 RK Breda, the Netherlands 
d Canisius Wilhelmina Hospital, Department of Pulmonary Medicine, Postbus 9015, 500GS Nijmegen, the Netherlands 

Corresponding author at: Amphia Hospital, Department of Pulmonary Medicine, Postbus 90158, 4800 RK Breda, the Netherlands.Amphia HospitalDepartment of Pulmonary MedicinePostbus 90158, 4800 RK Bredathe Netherlands

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Abstract

Introduction

We performed this study to describe clinical, radiological and pulmonary function outcomes of patients with COVID-19 pneumonia 1 year after discharge from hospital.

Methods

This is a prospective longitudinal study on patients admitted with COVID-19 pneumonia in March and April 2020. 162 patients were classified as moderate, severe or critical. Symptoms and pulmonary function were assessed at 3 months and 1 year after discharge. Chest CT scans were made during hospital admission, at 3 months and, in case of persistent radiological abnormalities, after 1 year.

Results

54% of patients reported full recovery of their pre-illness fitness after 1 year. 53% still reported exertional dyspnoea, independent of illness severity. DLCOc < 80% after 1 year was found in 74% of critical, 50% of severe and 38% of moderate cases. For KCOc<80%, no between-group difference was found. Restriction (TLC<80%) was found in 28% of critical, 5% of severe, and 13% of moderate cases. At baseline, chest CT score was significantly higher for the critical illness group, but after 1 year, there was no significant difference. Most resolution of abnormalities occurred before 3 months. A high prevalence of fibrotic lesions (24%) and subpleural banding (27%) was found.

Conclusion/clinical implication

A large proportion of patients experience consequences of COVID-19 pneumonia one year after discharge, irrespective of initial disease severity. Follow-up of patients admitted with COVID-19 is therefore warranted. An evaluation of symptoms, pulmonary function and radiology three months after discharge can discriminate between patients with early complete recovery and those with persistent abnormalities.

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Keywords : COVID-19, Pneumonia, Pulmonary function, Radiology, Dyspnoea


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Articolo 101001- giugno 2023 Ritorno al numero
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