Post-COVID dyspnea: prevalence, predictors, and outcomes in a longitudinal, prospective cohort.


Journal

BMC pulmonary medicine
ISSN: 1471-2466
Titre abrégé: BMC Pulm Med
Pays: England
ID NLM: 100968563

Informations de publication

Date de publication:
13 Mar 2023
Historique:
received: 28 11 2022
accepted: 28 02 2023
entrez: 13 3 2023
pubmed: 14 3 2023
medline: 15 3 2023
Statut: epublish

Résumé

The pathophysiology, evolution, and associated outcomes of post-COVID dyspnea remain unknown. The aim of this study was to determine the prevalence, severity, and predictors of dyspnea 12 months following hospitalization for COVID-19, and to describe the respiratory, cardiac, and patient-reported outcomes in patients with post-COVID dyspnea. We enrolled a prospective cohort of all adult patients admitted to 2 academic hospitals in Vancouver, Canada with PCR-confirmed SARS-CoV-2 during the first wave of COVID between March and June 2020. Dyspnea was measured 3, 6, and 12 months after initial symptom onset using the University of California San Diego Shortness of Breath Questionnaire. A total of 76 patients were included. Clinically meaningful dyspnea (baseline score > 10 points) was present in 49% of patients at 3 months and 46% at 12 months following COVID-19. Between 3 and 12 months post-COVID-19, 24% patients had a clinically meaningful worsening in their dyspnea, 49% had no meaningful change, and 28% had a clinically meaningful improvement in their dyspnea. There was worse sleep, mood, quality of life, and frailty in patients with clinically meaningful dyspnea at 12 months post-COVID infection compared to patients without dyspnea. There was no difference in PFT findings, troponin, or BNP comparing patients with and without clinically meaningful dyspnea at 12 months. Severity of dyspnea and depressive symptoms at 3 months predicted severity of dyspnea at 12 months. Post-COVID dyspnea is common, persistent, and negatively impacts quality of life. Mood abnormalities may play a causative role in post-COVID dyspnea in addition to potential cardiorespiratory abnormalities. Dyspnea and depression at initial follow-up predict longer-term post-COVID dyspnea, emphasizing that standardized dyspnea and mood assessment following COVID-19 may identify patients at high risk of post-COVID dyspnea and facilitating early and effective management.

Sections du résumé

BACKGROUND BACKGROUND
The pathophysiology, evolution, and associated outcomes of post-COVID dyspnea remain unknown. The aim of this study was to determine the prevalence, severity, and predictors of dyspnea 12 months following hospitalization for COVID-19, and to describe the respiratory, cardiac, and patient-reported outcomes in patients with post-COVID dyspnea.
METHODS METHODS
We enrolled a prospective cohort of all adult patients admitted to 2 academic hospitals in Vancouver, Canada with PCR-confirmed SARS-CoV-2 during the first wave of COVID between March and June 2020. Dyspnea was measured 3, 6, and 12 months after initial symptom onset using the University of California San Diego Shortness of Breath Questionnaire.
RESULTS RESULTS
A total of 76 patients were included. Clinically meaningful dyspnea (baseline score > 10 points) was present in 49% of patients at 3 months and 46% at 12 months following COVID-19. Between 3 and 12 months post-COVID-19, 24% patients had a clinically meaningful worsening in their dyspnea, 49% had no meaningful change, and 28% had a clinically meaningful improvement in their dyspnea. There was worse sleep, mood, quality of life, and frailty in patients with clinically meaningful dyspnea at 12 months post-COVID infection compared to patients without dyspnea. There was no difference in PFT findings, troponin, or BNP comparing patients with and without clinically meaningful dyspnea at 12 months. Severity of dyspnea and depressive symptoms at 3 months predicted severity of dyspnea at 12 months.
CONCLUSIONS CONCLUSIONS
Post-COVID dyspnea is common, persistent, and negatively impacts quality of life. Mood abnormalities may play a causative role in post-COVID dyspnea in addition to potential cardiorespiratory abnormalities. Dyspnea and depression at initial follow-up predict longer-term post-COVID dyspnea, emphasizing that standardized dyspnea and mood assessment following COVID-19 may identify patients at high risk of post-COVID dyspnea and facilitating early and effective management.

Identifiants

pubmed: 36907855
doi: 10.1186/s12890-023-02376-w
pii: 10.1186/s12890-023-02376-w
pmc: PMC10008721
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

84

Informations de copyright

© 2023. The Author(s).

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Auteurs

Japnam S Grewal (JS)

Department of Medicine, University of British Columbia, Vancouver, Canada.

Christopher Carlsten (C)

Department of Medicine, University of British Columbia, Vancouver, Canada.

James C Johnston (JC)

Department of Medicine, University of British Columbia, Vancouver, Canada.

Aditi S Shah (AS)

Department of Medicine, University of British Columbia, Vancouver, Canada.

Alyson W Wong (AW)

Department of Medicine, University of British Columbia, Vancouver, Canada.
Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada.

Christopher J Ryerson (CJ)

Department of Medicine, University of British Columbia, Vancouver, Canada. Chris.Ryerson@hli.ubc.ca.
Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada. Chris.Ryerson@hli.ubc.ca.

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Classifications MeSH