Cardiopulmonary recovery after COVID-19: an observational prospective multicentre trial.

COVID-19 Humans Lung / diagnostic imaging Prospective Studies Pulmonary Fibrosis SARS-CoV-2

Journal

The European respiratory journal
ISSN: 1399-3003
Titre abrégé: Eur Respir J
Pays: England
ID NLM: 8803460

Informations de publication

Date de publication:
04 2021
Historique:
received: 11 09 2020
accepted: 18 11 2020
pubmed: 12 12 2020
medline: 22 6 2021
entrez: 11 12 2020
Statut: epublish

Résumé

After the 2002/2003 severe acute respiratory syndrome outbreak, 30% of survivors exhibited persisting structural pulmonary abnormalities. The long-term pulmonary sequelae of coronavirus disease 2019 (COVID-19) are yet unknown, and comprehensive clinical follow-up data are lacking. In this prospective, multicentre, observational study, we systematically evaluated the cardiopulmonary damage in subjects recovering from COVID-19 at 60 and 100 days after confirmed diagnosis. We conducted a detailed questionnaire, clinical examination, laboratory testing, lung function analysis, echocardiography and thoracic low-dose computed tomography (CT). Data from 145 COVID-19 patients were evaluated, and 41% of all subjects exhibited persistent symptoms 100 days after COVID-19 onset, with dyspnoea being most frequent (36%). Accordingly, patients still displayed an impaired lung function, with a reduced diffusing capacity in 21% of the cohort being the most prominent finding. Cardiac impairment, including a reduced left ventricular function or signs of pulmonary hypertension, was only present in a minority of subjects. CT scans unveiled persisting lung pathologies in 63% of patients, mainly consisting of bilateral ground-glass opacities and/or reticulation in the lower lung lobes, without radiological signs of pulmonary fibrosis. Sequential follow-up evaluations at 60 and 100 days after COVID-19 onset demonstrated a vast improvement of symptoms and CT abnormalities over time. A relevant percentage of post-COVID-19 patients presented with persisting symptoms and lung function impairment along with radiological pulmonary abnormalities >100 days after the diagnosis of COVID-19. However, our results indicate a significant improvement in symptoms and cardiopulmonary status over time.

Sections du résumé

BACKGROUND
After the 2002/2003 severe acute respiratory syndrome outbreak, 30% of survivors exhibited persisting structural pulmonary abnormalities. The long-term pulmonary sequelae of coronavirus disease 2019 (COVID-19) are yet unknown, and comprehensive clinical follow-up data are lacking.
METHODS
In this prospective, multicentre, observational study, we systematically evaluated the cardiopulmonary damage in subjects recovering from COVID-19 at 60 and 100 days after confirmed diagnosis. We conducted a detailed questionnaire, clinical examination, laboratory testing, lung function analysis, echocardiography and thoracic low-dose computed tomography (CT).
RESULTS
Data from 145 COVID-19 patients were evaluated, and 41% of all subjects exhibited persistent symptoms 100 days after COVID-19 onset, with dyspnoea being most frequent (36%). Accordingly, patients still displayed an impaired lung function, with a reduced diffusing capacity in 21% of the cohort being the most prominent finding. Cardiac impairment, including a reduced left ventricular function or signs of pulmonary hypertension, was only present in a minority of subjects. CT scans unveiled persisting lung pathologies in 63% of patients, mainly consisting of bilateral ground-glass opacities and/or reticulation in the lower lung lobes, without radiological signs of pulmonary fibrosis. Sequential follow-up evaluations at 60 and 100 days after COVID-19 onset demonstrated a vast improvement of symptoms and CT abnormalities over time.
CONCLUSION
A relevant percentage of post-COVID-19 patients presented with persisting symptoms and lung function impairment along with radiological pulmonary abnormalities >100 days after the diagnosis of COVID-19. However, our results indicate a significant improvement in symptoms and cardiopulmonary status over time.

Identifiants

DOI: 10.1183/13993003.03481-2020 PMID: 33303539 PMC: PMC7736754
pubmed: 33303539
pii: 13993003.03481-2020
doi: 10.1183/13993003.03481-2020
pmc: PMC7736754
pii:
doi:

Banques de données

ClinicalTrials.gov
['NCT04416100']

Types de publication

Journal Article Multicenter Study Observational Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Commentaires et corrections

Type : CommentIn
Type : CommentIn

Informations de copyright

Copyright ©ERS 2021.

Déclaration de conflit d'intérêts

Conflict of interest: T. Sonnweber has nothing to disclose. Conflict of interest: S. Sahanic has nothing to disclose. Conflict of interest: A. Pizzini has nothing to disclose. Conflict of interest: A. Luger has nothing to disclose. Conflict of interest: C. Schwabl has nothing to disclose. Conflict of interest: B. Sonnweber has nothing to disclose. Conflict of interest: K. Kurz has nothing to disclose. Conflict of interest: S. Koppelstätter has nothing to disclose. Conflict of interest: D. Haschka has nothing to disclose. Conflict of interest: V. Petzer has nothing to disclose. Conflict of interest: A. Boehm has nothing to disclose. Conflict of interest: M. Aichner has nothing to disclose. Conflict of interest: P. Tymoszuk has nothing to disclose. Conflict of interest: D. Lener has nothing to disclose. Conflict of interest: M. Theurl has nothing to disclose. Conflict of interest: A. Lorsbach-Köhler has nothing to disclose. Conflict of interest: A. Tancevski has nothing to disclose. Conflict of interest: A. Schapfl has nothing to disclose. Conflict of interest: M. Schaber has nothing to disclose. Conflict of interest: R. Hilbe has nothing to disclose. Conflict of interest: M. Nairz has nothing to disclose. Conflict of interest: B. Puchner has nothing to disclose. Conflict of interest: D. Hüttenberger has nothing to disclose. Conflict of interest: C. Tschurtschenthaler has nothing to disclose. Conflict of interest: M. Aßhoff has nothing to disclose. Conflict of interest: A. Peer has nothing to disclose. Conflict of interest: F. Hartig has nothing to disclose. Conflict of interest: R. Bellmann has nothing to disclose. Conflict of interest: M. Joannidis has nothing to disclose. Conflict of interest: C. Gollmann-Tepeköylü has nothing to disclose. Conflict of interest: J. Holfeld has nothing to disclose. Conflict of interest: G. Feuchtner has nothing to disclose. Conflict of interest: A. Egger has nothing to disclose. Conflict of interest: G. Hoermann has nothing to disclose. Conflict of interest: A. Schroll has nothing to disclose. Conflict of interest: G. Fritsche has nothing to disclose. Conflict of interest: S. Wildner has nothing to disclose. Conflict of interest: R. Bellmann-Weiler has nothing to disclose. Conflict of interest: R. Kirchmair has nothing to disclose. Conflict of interest: R. Helbok has nothing to disclose. Conflict of interest: H. Prosch has nothing to disclose. Conflict of interest: D. Rieder has nothing to disclose. Conflict of interest: Z. Trajanoski has nothing to disclose. Conflict of interest: F. Kronenberg has nothing to disclose. Conflict of interest: E. Wöll has nothing to disclose. Conflict of interest: G. Weiss has nothing to disclose. Conflict of interest: G. Widmann has nothing to disclose. Conflict of interest: J. Löffler-Ragg has nothing to disclose. Conflict of interest: I. Tancevski reports an Investigator Initiated Study (IIS) grant from Boehringer Ingelheim (IIS 1199-0424).

Auteurs

Thomas Sonnweber (T)

Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.
Contributed equally as first authors.
ORCID: 0000-0002-5080-386X

Sabina Sahanic (S)

Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.
Contributed equally as first authors.

Alex Pizzini (A)

Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.
ORCID: 0000-0003-3699-1822

Anna Luger (A)

Dept of Radiology, Medical University of Innsbruck, Innsbruck, Austria.

Christoph Schwabl (C)

Dept of Radiology, Medical University of Innsbruck, Innsbruck, Austria.

Bettina Sonnweber (B)

Dept of Internal Medicine, St Vinzenz Hospital, Zams, Austria.

Katharina Kurz (K)

Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.
ORCID: 0000-0003-4958-9541

Sabine Koppelstätter (S)

Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.

David Haschka (D)

Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.

Verena Petzer (V)

Dept of Internal Medicine V, Medical University of Innsbruck, Innsbruck, Austria.

Anna Boehm (A)

Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.
ORCID: 0000-0001-7871-5354

Magdalena Aichner (M)

Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.

Piotr Tymoszuk (P)

Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.
ORCID: 0000-0002-0398-6034

Daniela Lener (D)

Dept of Internal Medicine III, Medical University of Innsbruck, Innsbruck, Austria.
ORCID: 0000-0002-3464-0343

Markus Theurl (M)

Dept of Internal Medicine III, Medical University of Innsbruck, Innsbruck, Austria.

Almut Lorsbach-Köhler (A)

Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.

Amra Tancevski (A)

Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.
ORCID: 0000-0001-5116-8960

Anna Schapfl (A)

Dept of Internal Medicine, St Vinzenz Hospital, Zams, Austria.

Marc Schaber (M)

Dept of Internal Medicine, St Vinzenz Hospital, Zams, Austria.

Richard Hilbe (R)

Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.

Manfred Nairz (M)

Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.

Bernhard Puchner (B)

The Karl Landsteiner Institute, Reha Zentrum Münster, Münster, Austria.

Doris Hüttenberger (D)

Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.

Christoph Tschurtschenthaler (C)

Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.

Malte Aßhoff (M)

Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.

Andreas Peer (A)

Division of Intensive Care and Emergency Medicine, Dept of Internal Medicine I, Medical University of Innsbruck, Innsbruck, Austria.

Frank Hartig (F)

Division of Intensive Care and Emergency Medicine, Dept of Internal Medicine I, Medical University of Innsbruck, Innsbruck, Austria.

Romuald Bellmann (R)

Division of Intensive Care and Emergency Medicine, Dept of Internal Medicine I, Medical University of Innsbruck, Innsbruck, Austria.

Michael Joannidis (M)

Division of Intensive Care and Emergency Medicine, Dept of Internal Medicine I, Medical University of Innsbruck, Innsbruck, Austria.

Can Gollmann-Tepeköylü (C)

Dept of Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria.
ORCID: 0000-0001-6584-3488

Johannes Holfeld (J)

Dept of Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria.

Gudrun Feuchtner (G)

Dept of Radiology, Medical University of Innsbruck, Innsbruck, Austria.
ORCID: 0000-0001-6755-4399

Alexander Egger (A)

Central Institute of Medical and Chemical Laboratory Diagnostics, University Hospital Innsbruck, Innsbruck, Austria.

Gregor Hoermann (G)

Central Institute of Medical and Chemical Laboratory Diagnostics, University Hospital Innsbruck, Innsbruck, Austria.
Dept of Laboratory Medicine, Medical University of Vienna, Vienna, Austria.
MLL Munich Leukemia Laboratory, Munich, Germany.

Andrea Schroll (A)

Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.

Gernot Fritsche (G)

Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.

Sophie Wildner (S)

Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.

Rosa Bellmann-Weiler (R)

Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.

Rudolf Kirchmair (R)

Dept of Internal Medicine III, Medical University of Innsbruck, Innsbruck, Austria.
The Karl Landsteiner Institute, Reha Zentrum Münster, Münster, Austria.

Raimund Helbok (R)

Dept of Neurology, Medical University of Innsbruck, Innsbruck, Austria.

Helmut Prosch (H)

Dept of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Vienna, Austria.
ORCID: 0000-0002-6119-6364

Dietmar Rieder (D)

Institute for Bioinformatics, Medical University of Innsbruck, Innsbruck, Austria.

Zlatko Trajanoski (Z)

Institute for Bioinformatics, Medical University of Innsbruck, Innsbruck, Austria.

Florian Kronenberg (F)

Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria.

Ewald Wöll (E)

Dept of Internal Medicine, St Vinzenz Hospital, Zams, Austria.

Günter Weiss (G)

Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.
ORCID: 0000-0003-0709-2158

Gerlig Widmann (G)

Dept of Radiology, Medical University of Innsbruck, Innsbruck, Austria.
Contributed equally to this article as lead authors and supervised the work.

Judith Löffler-Ragg (J)

Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.
Contributed equally to this article as lead authors and supervised the work.

Ivan Tancevski (I)

Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.
Contributed equally to this article as lead authors and supervised the work.
ORCID: 0000-0001-5116-8960

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Classifications MeSH

questionsmedicales.fr › Maladies de l'appareil respiratoire › Infections de l'appareil respiratoire › Pneumopathie infectieuse › Pneumopathie virale › COVID-19 › Cardiopulmonary recovery after COVID-19: an...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Cardiopulmonary recovery after COVID-19: an...
questionsmedicales.fr › Appareil respiratoire › Poumon › Cardiopulmonary recovery after COVID-19: an...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études prospectives › Cardiopulmonary recovery after COVID-19: an...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Fibrose › Fibrose pulmonaire › Cardiopulmonary recovery after COVID-19: an...
questionsmedicales.fr › Virus › Virus à ARN › Virus à ARN à brin positif › Nidovirales › Coronaviridae › Coronavirus › Betacoronavirus › Virus du SRAS › SARS-CoV-2 › Cardiopulmonary recovery after COVID-19: an...