Skip to main content

Main menu

  • Home
  • Current issue
  • Early View
  • Archive
  • Authors/reviewers
    • Instructions for authors
    • Submit a manuscript
    • Institutional open access agreements
    • Peer reviewer login
  • Alerts
  • Subscriptions
  • ERS Publications
    • European Respiratory Journal
    • ERJ Open Research
    • European Respiratory Review
    • Breathe
    • ERS Books
    • ERS publications home

User menu

  • Log in
  • Subscribe
  • Contact Us
  • My Cart

Search

  • Advanced search
  • ERS Publications
    • European Respiratory Journal
    • ERJ Open Research
    • European Respiratory Review
    • Breathe
    • ERS Books
    • ERS publications home

Login

European Respiratory Society

Advanced Search

  • Home
  • Current issue
  • Early View
  • Archive
  • Authors/reviewers
    • Instructions for authors
    • Submit a manuscript
    • Institutional open access agreements
    • Peer reviewer login
  • Alerts
  • Subscriptions

Characteristics and risk factors for post-COVID-19 breathlessness after hospitalisation for COVID-19

Luke Daines, Bang Zheng, Omer Elneima, Ewen Harrison, Nazir I. Lone, John R. Hurst, Jeremy S. Brown, Elizabeth Sapey, James D. Chalmers, Jennifer K. Quint, Paul Pfeffer, Salman Siddiqui, Samantha Walker, Krisnah Poinasamy, Hamish McAuley, Marco Sereno, Aarti Shikotra, Amisha Singapuri, Annemarie B. Docherty, Michael Marks, Mark Toshner, Luke S. Howard, Alex Horsley, Gisli Jenkins, Joanna C. Porter, Ling-Pei Ho, Betty Raman, Louise V. Wain, Christopher E. Brightling, Rachael A. Evans, Liam G. Heaney, Anthony De Soyza, Aziz Sheikh on behalf of the PHOSP-COVID Study Collaborative Group
ERJ Open Research 2023 9: 00274-2022; DOI: 10.1183/23120541.00274-2022
Luke Daines
1Usher Institute, University of Edinburgh, Edinburgh, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Luke Daines
Bang Zheng
1Usher Institute, University of Edinburgh, Edinburgh, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Omer Elneima
2The Institute for Lung Health, Leicester NIHR Biomedical Research Centre, University of Leicester, Leicester, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Ewen Harrison
1Usher Institute, University of Edinburgh, Edinburgh, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Nazir I. Lone
1Usher Institute, University of Edinburgh, Edinburgh, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Nazir I. Lone
John R. Hurst
3UCL Respiratory, University College London, London, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for John R. Hurst
Jeremy S. Brown
3UCL Respiratory, University College London, London, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Elizabeth Sapey
4Centre for Translational Inflammation Research, University of Birmingham, Birmingham, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Elizabeth Sapey
James D. Chalmers
5School of Medicine, University of Dundee, Dundee, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jennifer K. Quint
6National Heart and Lung Institute, Imperial College London, London, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Jennifer K. Quint
Paul Pfeffer
7Barts Health NHS Trust and Queen Mary University of London, London, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Salman Siddiqui
2The Institute for Lung Health, Leicester NIHR Biomedical Research Centre, University of Leicester, Leicester, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Samantha Walker
8Asthma + Lung UK, London, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Krisnah Poinasamy
8Asthma + Lung UK, London, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Hamish McAuley
2The Institute for Lung Health, Leicester NIHR Biomedical Research Centre, University of Leicester, Leicester, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Hamish McAuley
Marco Sereno
2The Institute for Lung Health, Leicester NIHR Biomedical Research Centre, University of Leicester, Leicester, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Aarti Shikotra
2The Institute for Lung Health, Leicester NIHR Biomedical Research Centre, University of Leicester, Leicester, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Amisha Singapuri
2The Institute for Lung Health, Leicester NIHR Biomedical Research Centre, University of Leicester, Leicester, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Annemarie B. Docherty
1Usher Institute, University of Edinburgh, Edinburgh, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Michael Marks
9Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Michael Marks
Mark Toshner
10Heart Lung Research Institute, Department of Medicine, University of Cambridge, Cambridge, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Mark Toshner
Luke S. Howard
11Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Luke S. Howard
Alex Horsley
12Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Alex Horsley
Gisli Jenkins
6National Heart and Lung Institute, Imperial College London, London, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Joanna C. Porter
3UCL Respiratory, University College London, London, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Joanna C. Porter
Ling-Pei Ho
13MRC Weatherall Institute of Molecular Medicine, Oxford University, Oxford, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Betty Raman
14Radcliffe Department of Medicine, University of Oxford, Oxford, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Betty Raman
Louise V. Wain
15Department of Health Sciences and NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Louise V. Wain
Christopher E. Brightling
2The Institute for Lung Health, Leicester NIHR Biomedical Research Centre, University of Leicester, Leicester, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Rachael A. Evans
2The Institute for Lung Health, Leicester NIHR Biomedical Research Centre, University of Leicester, Leicester, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Rachael A. Evans
Liam G. Heaney
16Centre for Experimental Medicine, Queen's University Belfast, Belfast, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Anthony De Soyza
17Population Health Science Institute, Newcastle University, Newcastle, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Anthony De Soyza
Aziz Sheikh
1Usher Institute, University of Edinburgh, Edinburgh, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: aziz.sheikh@ed.ac.uk
  • Article
  • Figures & Data
  • Info & Metrics
  • PDF
Loading

Figures

  • Tables
  • Supplementary Materials
  • FIGURE 1
    • Download figure
    • Open in new tab
    • Download powerpoint
    FIGURE 1

    Flow diagram of participants. PSQ: patient symptom questionnaire; BNP: B-type natriuretic peptide; NT-pro-BNP: N-terminal pro-BNP.

  • FIGURE 2
    • Download figure
    • Open in new tab
    • Download powerpoint
    FIGURE 2

    Dates of discharge and research visit for the 1226 study participants.

  • FIGURE 3
    • Download figure
    • Open in new tab
    • Download powerpoint
    FIGURE 3

    Multivariable logistic regression for post-COVID-19 breathlessness. BMI: body mass index; WHO: World Health Organization.

Tables

  • Figures
  • Supplementary Materials
  • TABLE 1

    Patient characteristics

    Total, N (%)Post-COVID-19 breathlessnessTotal
    NoYes
    Total, N (%)611 (49.8)615 (50.2)1226
    Age at admission, years1213 (98.9)
     <3010 (1.6)15 (2.4)25 (2.0)
     30–3938 (6.2)41 (6.7)79 (6.4)
     40–4987 (14.2)103 (16.7)190 (15.5)
     50–59151 (24.7)203 (33.0)354 (28.9)
     60–69183 (30.0)174 (28.3)357 (29.1)
     70–79107 (17.5)61 (9.9)168 (13.7)
     ≥8029 (4.7)11 (1.8)40 (3.3)
     Data missing6 (1.0)7 (1.1)13 (1.1)
    Sex at birth1226 (100.0)
     Male416 (68.1)352 (57.2)768 (62.6)
     Female195 (31.9)263 (42.8)458 (37.4)
    Ethnicity1203 (98.1)
     White422 (69.1)451 (73.3)873 (71.2)
     South Asian82 (13.4)71 (11.5)153 (12.5)
     Black52 (8.5)40 (6.5)92 (7.5)
     Mixed17 (2.8)16 (2.6)33 (2.7)
     Other27 (4.4)25 (4.1)52 (4.2)
     Data missing11 (1.8)12 (2.0)23 (1.9)
    Index of Multiple Deprivation1204 (98.2)
     1, most deprived112 (18.3)154 (25.0)266 (21.7)
     2135 (22.1)131 (21.3)266 (21.7)
     3116 (19.0)112 (18.2)228 (18.6)
     4111 (18.2)103 (16.7)214 (17.5)
     5, least deprived127 (20.8)103 (16.7)230 (18.8)
     Data missing10 (1.6)12 (2.0)22 (1.8)
    BMI, kg·m−2, mean±sd1090 (88.9)31.4±7.132.7±7.132.0±7.1
    Smoking1213 (98.9)
     Never-smokers350 (57.3)339 (55.1)689 (56.2)
     Ex-smokers246 (40.3)260 (42.3)506 (41.3)
     Current smokers7 (1.1)11 (1.8)18 (1.5)
     Data missing8 (1.3)5 (0.8)13 (1.1)
    Number of comorbidities, median (IQR)1226 (100.0)2.0 (0.0–3.0)2.0 (1.0–4.0)2.0 (0.0–3.0)
    Pre-existing cardiovascular condition1226 (100.0)
     No329 (53.8)350 (56.9)679 (55.4)
     Yes282 (46.2)265 (43.1)547 (44.6)
    Pre-existing respiratory condition1226 (100.0)
     No449 (73.5)444 (72.2)893 (72.8)
     Yes162 (26.5)171 (27.8)333 (27.2)
    Pre-existing depression or anxiety1207 (98.5)
     No538 (88.1)471 (76.6)1009 (82.3)
     Yes66 (10.8)132 (21.5)198 (16.2)
     Data missing7 (1.1)12 (2.0)19 (1.5)
    Breathlessness before COVID-19, PSQ1226 (100.0)
     0374 (61.2)407 (66.2)781 (63.7)
     1–2103 (16.9)128 (20.8)231 (18.8)
     ≥3134 (21.9)80 (13.0)214 (17.5)

    Data are presented as n (%) unless otherwise stated. BMI: body mass index; IQR: interquartile range; PSQ: Patient Symptom Questionnaire.

    • TABLE 2

      Patient characteristics available during hospital admission

      Total, N (%)Post-COVID-19 breathlessnessTotal
      NoYes
      Total, N (%)611 (49.8)615 (50.2)1226
      Admission duration, days, median (IQR)1225 (99.9)7.0 (4.0–14.0)9.0 (4.0–22.0)8.0 (4.0–17.0)
      SARS-CoV-2 PCR result1137 (92.7)
       Negative47 (7.7)51 (8.3)98 (8.0)
       Positive522 (85.4)517 (84.1)1039 (84.7)
       Data missing42 (6.9)47 (7.3)89 (7.3)
      WHO clinical progression scale1226 (100.0)
       WHO class 3–4110 (18.0)113 (18.4)223 (18.2)
       WHO class 5252 (41.2)225 (36.6)477 (38.9)
       WHO class 6136 (22.3)120 (19.5)256 (20.9)
       WHO class 7–9113 (18.5)157 (25.5)270 (22.0)
      Proning during mechanical ventilation1102 (89.9)
       No466 (76.3)426 (69.3)892 (72.8)
       Yes87 (14.2)123 (20.0)210 (17.1)
       Data missing58 (9.5)66 (10.7)124 (10.1)
      Pulmonary embolism1146 (93.5)
       No518 (84.8)507 (82.4)1025 (83.6)
       Yes56 (9.2)65 (10.6)121 (9.9)
       Data missing37 (6.1)43 (7.0)80 (6.5)
      Coronary thrombosis1140 (93.0)
       No570 (93.3)565 (91.9)1135 (92.6)
       Yes<5<55 (0.4)
       Data missing86 (7.0)
      Antibiotic therapy1187 (96.8)
       No115 (18.8)121 (19.7)236 (19.2)
       Yes477 (78.1)474 (77.1)951 (77.6)
       Data missing19 (3.1)20 (3.3)39 (3.2)
      Systemic steroids, oral or i.v.1144 (93.3)
       No319 (52.2)294 (47.8)613 (50.0)
       Yes250 (40.9)281 (45.7)531 (43.3)
       Data missing42 (6.9)40 (6.5)82 (6.7)
      Therapeutic dose anticoagulation1150 (93.8)
       No352 (57.6)333 (54.1)685 (55.9)
       Yes220 (36.0)245 (39.8)465 (37.9)
       Data missing39 (6.4)37 (6.0)76 (6.2)

      Data are presented as n (%) unless otherwise stated. World Health Organization (WHO) clinical progression scale: not requiring continuous supplemental oxygen (levels 3–4); continuous supplemental oxygen only (level 5); continuous positive airway pressure ventilation, bilevel positive airway pressure or high-flow nasal oxygen (level 6); invasive mechanical ventilation, extra-corporeal membrane oxygenation and acute renal replacement therapy (levels 7–9). n<5 and related subtotals have been suppressed. IQR: interquartile range.

      • TABLE 3

        Patient characteristics available at the research visit

        Total, N (%)Post-COVID-19 breathlessnessTotalOR (95% CI)
        NoYes
        Total, N (%)611 (49.8)615 (50.2)1226
        Discharge to review period, months1226 (100.0)4.7 (3.4–6.0)4.7 (3.3–6.0)4.7 (3.4–6.0)1.00 (1.00–1.00)
        Breathlessness at research visit, PSQ1226 (100.0)
         0462 (75.6)0 (0.0)462 (37.7)
         1–270 (11.5)143 (23.3)213 (17.4)
         ≥379 (12.9)472 (76.7)551 (44.9)
        PHQ-9 total score1188 (96.9)3.0 (1.0–8.0)8.0 (3.0–13.0)5.0 (2.0–11.0)1.09 (1.07–1.12)
        GAD-7 total score1187 (96.8)2.0 (0.0–6.0)5.0 (1.0–11.0)3.0 (0.0–8.0)1.07 (1.05–1.09)
        PCL-5 total severity score1184 (96.6)6.0 (2.0–15.0)15.0 (5.0–31.2)9.0 (3.0–23.0)1.03 (1.02–1.04)
        CRP, mg·L−1800 (65.3)4.0 (1.4–5.0)4.0 (2.0–5.0)4.0 (1.8–5.0)1.01 (0.99–1.04)
        BNP/NT-pro-BNP above threshold642 (52.4)0.65 (0.32–1.33)
         No293 (48.0)304 (49.4)597 (48.7)
         Yes29 (4.7)16 (2.6)45 (3.7)
        Haemoglobin, g·dL−1861 (70.2)14.4 (13.3–15.2)14.0 (13.1–15.0)14.2 (13.2–15.2)0.88 (0.79–0.98)
         Males537 (43.8)14.7 (13.9–15.6)14.6 (13.6–15.5)14.7 (13.8–15.5)0.90 (0.79–1.03)
         Females324 (26.4)13.5 (12.8–14.3)13.4 (12.6–14.0)13.4 (12.7–14.1)0.80 (0.65–0.99)
        ISWT distance, m737 (60.1)440.0 (270.0–615.0)350.0 (230.0–540.0)380.0 (257.5–570.0)0.91 (0.85–0.97)#
        ISWT, % predicted658 (53.7)60.5 (42.0–81.9)52.5 (35.1–71.2)56.3 (37.9–75.9)0.99 (0.98–1.00)
        Oxygen saturations post-ISWT, %727 (59.3)96.0 (94.0–98.0)96.0 (94.0–98.0)96.0 (94.0–98.0)0.98 (0.94–1.02)
        Borg leg fatigue score post-ISWT722 (58.9)2.0 (0.5–3.0)3.0 (2.0–4.0)3.0 (1.0–4.0)1.14 (1.06–1.23)
        FEV1, L748 (61.0)2.8 (2.3–3.4)2.7 (2.2–3.3)2.8 (2.2–3.3)0.96 (0.81–1.15)
        FEV1, % predicted683 (55.7)93.9 (83.4–105.7)89.9 (77.9–101.3)91.7 (79.7–103.7)1.00 (0.99–1.00)
        FEV1 <LLN683 (55.7)1.61 (1.05–2.45)
         No274 (85.4)284 (78.5)558 (81.7)
         Yes47 (14.6)78 (21.5)125 (18.3)
        FVC, L746 (60.8)3.6 (2.9–4.3)3.3 (2.6–4.0)3.5 (2.8–4.2)0.70 (0.57–0.86)
        FVC, % predicted681 (55.5)93.7 (83.0–105.4)86.8 (74.5–98.5)90.0 (78.2–102.4)0.98 (0.97–0.99)
        FVC <LLN681 (55.5)2.43 (1.60–3.70)
         No276 (86.2)260 (72.0)536 (78.7)
         Yes44 (13.8)101 (28.0)145 (21.3)
        FEV1/FVC ratio, %736 (60.0)79.4 (73.9–84.0)81.6 (77.3–86.0)80.6 (76.0–85.5)1.04 (1.02–1.06)
        FEV1/FVC <LLN673 (54.9)0.58 (0.28–1.19)
         No295 (93.1)342 (96.1)637 (94.7)
         Yes22 (6.9)14 (3.9)36 (5.3)
        TLCO, mmol·min−1·kPa−1272 (22.2)7.6 (6.4–8.7)6.8 (5.8–8.3)7.3 (6.1–8.4)0.94 (0.83–1.07)
        TLCO, % predicted252 (20.6)90.1 (78.6–102.7)90.7 (74.2–104.2)90.7 (76.8–103.2)0.99 (0.99–1.00)
        TLCO <80% predicted252 (20.6)1.48 (0.79–2.77)
         No86 (72.3)90 (67.7)176 (69.8)
         Yes33 (27.7)43 (32.3)76 (30.2)
        KCO, mmol·min−1·kPa−1·L−1276 (22.5)1.5 (1.3–1.6)1.5 (1.2–1.7)1.5 (1.3–1.6)0.49 (0.18–1.29)
        KCO, % predicted259 (21.1)103.5 (92.6–108.7)99.6 (87.4–112.3)101.8 (89.2–110.1)0.99 (0.97–1.00)
        KCO <80% predicted259 (21.1)1.43 (0.53–3.88)
         No112 (92.6)127 (92.0)239 (92.3)
         Yes9 (7.4)11 (8.0)20 (7.7)

        Data are presented as median (interquartile range) or n (%), unless otherwise stated. PSQ: Patient Symptom Questionnaire; PHQ-9: Patient Health Questionnaire-9; GAD-7: General Anxiety Disorder-7; PCL-5: Post Traumatic Stress Disorder Checklist; CRP: C-reactive protein; BNP: B-type natriuretic peptide; NT-pro-BNP: N-terminal pro-BNP; ISWT: incremental shuttle walk test; FEV1: forced expiratory volume in 1 s; LLN: lower limit of normal; FVC: forced vital capacity; TLCO: transfer capacity of the lung for carbon monoxide; KCO: carbon monoxide transfer coefficient. #: refers to the risk of worsening breathlessness for each 100 m achieved.

        • TABLE 4

          Multivariable logistic regression for post-COVID-19 breathlessness

          Post-COVID-19 breathlessnessOR (95% CI)
          NoYesUnivariableMultivariableMultiple imputation
          Sex at birth
           Male416 (54.2)352 (45.8)1 (ref)1 (ref)1 (ref)
           Female195 (42.6)263 (57.4)1.59 (1.26–2.01) (p<0.001)1.44 (1.10–1.90) (p=0.009)1.56 (1.21–2.00) (p=0.001)
          Age at admission, years
           <3010 (40.0)15 (60.0)1.12 (0.49–2.63) (p=0.795)1.20 (0.47–3.12) (p=0.706)1.35 (0.57–3.23) (p=0.498)
           30–3938 (48.1)41 (51.9)0.80 (0.49–1.31) (p=0.378)0.83 (0.48–1.44) (p=0.511)0.86 (0.51–1.44) (p=0.568)
           40–4987 (45.8)103 (54.2)0.88 (0.62–1.26) (p=0.482)0.96 (0.64–1.44) (p=0.832)0.96 (0.66–1.40) (p=0.832)
           50–59151 (42.7)203 (57.3)1 (ref)1 (ref)1 (ref)
           60–69183 (51.3)174 (48.7)0.71 (0.53–0.95) (p=0.022)0.62 (0.44–0.88) (p=0.007)0.70 (0.51–0.96) (p=0.025)
           70–79107 (63.7)61 (36.3)0.42 (0.29–0.62) (p<0.001)0.41 (0.26–0.64) (p<0.001)0.43 (0.28–0.64) (p<0.001)
           ≥8029 (72.5)11 (27.5)0.28 (0.13–0.57) (p=0.001)0.27 (0.11–0.60) (p=0.002)0.31 (0.14–0.66) (p=0.003)
          Index of Multiple Deprivation
           5, least deprived127 (55.2)103 (44.8)1 (ref)1 (ref)1 (ref)
           4111 (51.9)103 (48.1)1.14 (0.79–1.66) (p=0.480)1.30 (0.85–1.99) (p=0.220)1.22 (0.82–1.81) (p=0.328)
           3116 (50.9)112 (49.1)1.19 (0.82–1.72) (p=0.352)1.21 (0.80–1.84) (p=0.365)1.22 (0.82–1.79) (p=0.327)
           2135 (50.8)131 (49.2)1.20 (0.84–1.71) (p=0.321)1.31 (0.87–1.96) (p=0.195)1.20 (0.82–1.76) (p=0.338)
           1, most deprived112 (42.1)154 (57.9)1.70 (1.19–2.42) (p=0.004)1.87 (1.24–2.84) (p=0.003)1.67 (1.14–2.44) (p=0.009)
          Ethnicity
           White422 (48.3)451 (51.7)1 (ref)1 (ref)1 (ref)
           South Asian82 (53.6)71 (46.4)0.81 (0.57–1.14) (p=0.231)0.83 (0.55–1.26) (p=0.378)0.80 (0.55–1.17) (p=0.244)
           Black52 (56.5)40 (43.5)0.72 (0.46–1.11) (p=0.137)0.57 (0.34–0.95) (p=0.031)0.56 (0.35–0.89) (p=0.015)
           Mixed17 (51.5)16 (48.5)0.88 (0.44–1.77) (p=0.720)0.98 (0.44–2.20) (p=0.956)0.85 (0.41–1.75) (p=0.656)
           Other27 (51.9)25 (48.1)0.87 (0.49–1.52) (p=0.616)0.84 (0.44–1.62) (p=0.606)0.80 (0.44–1.44) (p=0.448)
          BMI, kg·m−231.4±7.132.7±7.11.03 (1.01–1.04) (p=0.002)1.08 (0.97–1.21) (p=0.164)1.08 (0.98–1.19) (p=0.107)
          Number of comorbidities2.0±2.02.4±2.31.09 (1.03–1.15) (p=0.002)1.09 (1.00–1.18) (p=0.049)1.08 (1.00–1.17) (p=0.049)
          Pre-existing respiratory condition
           No449 (50.3)444 (49.7)1 (ref)1 (ref)1 (ref)
           Yes162 (48.6)171 (51.4)1.07 (0.83–1.37) (p=0.611)0.85 (0.62–1.17) (p=0.312)0.82 (0.61–1.11) (p=0.195)
          Pre-existing depression or anxiety
           No538 (53.3)471 (46.7)1 (ref)1 (ref)1 (ref)
           Yes66 (33.3)132 (66.7)2.28 (1.66–3.16) (p<0.001)1.54 (1.00–2.38) (p=0.050)1.58 (1.06–2.35) (p=0.026)
          Admission duration, days13.2±17.217.2±22.21.01 (1.00–1.02) (p=0.001)1.01 (1.00–1.02) (p=0.064)1.01 (1.00–1.02) (p=0.002)
          WHO clinical progression scale
           WHO class 3–4110 (49.3)113 (50.7)1 (ref)1 (ref)1 (ref)
           WHO class 5252 (52.8)225 (47.2)0.87 (0.63–1.19) (p=0.388)0.88 (0.61–1.29) (p=0.522)0.84 (0.60–1.18) (p=0.314)
           WHO class 6136 (53.1)120 (46.9)0.86 (0.60–1.23) (p=0.407)0.90 (0.58–1.38) (p=0.619)0.80 (0.54–1.18) (p=0.260)
           WHO class 7–9113 (41.9)157 (58.1)1.35 (0.95–1.93) (p=0.097)1.17 (0.70–1.98) (p=0.548)0.92 (0.57–1.47) (p=0.715)

          Data are presented as n (%) or mean±sd, unless otherwise stated. The dependent variable was post-COVID-19 breathlessness. World Health Organization (WHO) clinical progression scale: not requiring continuous supplemental oxygen (levels 3–4); continuous supplemental oxygen only (level 5); continuous positive airway pressure ventilation, bilevel positive airway pressure or high-flow nasal oxygen (level 6); invasive mechanical ventilation, extra-corporeal membrane oxygenation and acute renal replacement therapy (levels 7–9). The logistic regression model also included body mass index (BMI)2.

          • TABLE 5

            Multinomial modelling for post-COVID-19 breathlessness

            Post-COVID-19 breathlessness OR (95% CI)
            MildSevere
            Sex at birth
             Male1 (ref)1 (ref)
             Female1.34 (0.95–1.88)1.67 (1.26–2.22)
            Age at admission, years
             <302.22 (0.78–6.33)0.95 (0.35–2.62)
             30–391.23 (0.62–2.43)0.68 (0.38–1.22)
             40–491.38 (0.84–2.26)0.78 (0.51–1.18)
             50–591 (ref)1 (ref)
             60–690.79 (0.51–1.23)0.64 (0.46–0.91)
             70–790.44 (0.25–0.80)0.39 (0.25–0.62)
             ≥800.58 (0.23–1.41)0.13 (0.04–0.44)
            Index of Multiple Deprivation
             5, least deprived1 (ref)1 (ref)
             41.14 (0.68–1.90)1.26 (0.79–2.00)
             31.05 (0.63–1.74)1.38 (0.88–2.18)
             20.82 (0.49–1.36)1.52 (0.99–2.35)
             1, most deprived1.02 (0.61–1.71)2.22 (1.44–3.44)
            Ethnicity
             White1 (ref)1 (ref)
             South Asian0.80 (0.49–1.33)0.74 (0.48–1.14)
             Black1.02 (0.61–1.71)0.46 (0.27–0.80)
             Mixed0.76 (0.27–2.15)0.88 (0.39–1.98)
             Other0.88 (0.39–1.96)0.77 (0.39–1.49)
            BMI, kg·m−20.99 (0.96–1.02)1.01 (0.99–1.04)
            Number of comorbidities1.12 (1.02–1.24)1.06 (0.98–1.16)
            Pre-existing respiratory condition
             No1 (ref)1 (ref)
             Yes0.94 (0.64–1.39)0.76 (0.55–1.07)
            Pre-existing depression or anxiety
             No1 (ref)1 (ref)
             Yes1.41 (0.83–2.38)1.64 (1.06–2.54)
            Admission duration, days1.01 (1.00–1.02)1.02 (1.01–1.02)
            WHO clinical progression scale
             WHO class 3–41 (ref)1 (ref)
             WHO class 50.92 (0.59–1.45)0.81 (0.55–1.20)
             WHO class 60.76 (0.45–1.31)0.83 (0.53–1.30)
             WHO class 7–90.90 (0.48–1.69)0.98 (0.58–1.65)

            The dependent variable was post-COVID-19 breathlessness categorised into three levels, No/Mild/Severe. The reference group (not shown) were those with no post-COVID-19 breathlessness (n=611). Mild post-COVID-19 breathlessness: n=213; severe post-COVID-19 breathlessness: n=402. World Health Organization (WHO) clinical progression scale: not requiring continuous supplemental oxygen (levels 3–4); continuous supplemental oxygen only (level 5); continuous positive airway pressure ventilation, bilevel positive airway pressure or high-flow nasal oxygen (level 6); invasive mechanical ventilation, extra-corporeal membrane oxygenation and acute renal replacement therapy (levels 7–9). BMI: body mass index.

            Supplementary Materials

            • Figures
            • Tables
            • Supplementary Material

              Please note: supplementary material is not edited by the Editorial Office, and is uploaded as it has been supplied by the author.

              Supplementary material 00274-2022.SUPPLEMENT

            PreviousNext
            Back to top
            Vol 9 Issue 1 Table of Contents
            ERJ Open Research: 9 (1)
            • Table of Contents
            • Index by author
            Email

            Thank you for your interest in spreading the word on European Respiratory Society .

            NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

            Enter multiple addresses on separate lines or separate them with commas.
            Characteristics and risk factors for post-COVID-19 breathlessness after hospitalisation for COVID-19
            (Your Name) has sent you a message from European Respiratory Society
            (Your Name) thought you would like to see the European Respiratory Society web site.
            CAPTCHA
            This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
            Print
            Citation Tools
            Characteristics and risk factors for post-COVID-19 breathlessness after hospitalisation for COVID-19
            Luke Daines, Bang Zheng, Omer Elneima, Ewen Harrison, Nazir I. Lone, John R. Hurst, Jeremy S. Brown, Elizabeth Sapey, James D. Chalmers, Jennifer K. Quint, Paul Pfeffer, Salman Siddiqui, Samantha Walker, Krisnah Poinasamy, Hamish McAuley, Marco Sereno, Aarti Shikotra, Amisha Singapuri, Annemarie B. Docherty, Michael Marks, Mark Toshner, Luke S. Howard, Alex Horsley, Gisli Jenkins, Joanna C. Porter, Ling-Pei Ho, Betty Raman, Louise V. Wain, Christopher E. Brightling, Rachael A. Evans, Liam G. Heaney, Anthony De Soyza, Aziz Sheikh
            ERJ Open Research Jan 2023, 9 (1) 00274-2022; DOI: 10.1183/23120541.00274-2022

            Citation Manager Formats

            • BibTeX
            • Bookends
            • EasyBib
            • EndNote (tagged)
            • EndNote 8 (xml)
            • Medlars
            • Mendeley
            • Papers
            • RefWorks Tagged
            • Ref Manager
            • RIS
            • Zotero
            Share
            Characteristics and risk factors for post-COVID-19 breathlessness after hospitalisation for COVID-19
            Luke Daines, Bang Zheng, Omer Elneima, Ewen Harrison, Nazir I. Lone, John R. Hurst, Jeremy S. Brown, Elizabeth Sapey, James D. Chalmers, Jennifer K. Quint, Paul Pfeffer, Salman Siddiqui, Samantha Walker, Krisnah Poinasamy, Hamish McAuley, Marco Sereno, Aarti Shikotra, Amisha Singapuri, Annemarie B. Docherty, Michael Marks, Mark Toshner, Luke S. Howard, Alex Horsley, Gisli Jenkins, Joanna C. Porter, Ling-Pei Ho, Betty Raman, Louise V. Wain, Christopher E. Brightling, Rachael A. Evans, Liam G. Heaney, Anthony De Soyza, Aziz Sheikh
            ERJ Open Research Jan 2023, 9 (1) 00274-2022; DOI: 10.1183/23120541.00274-2022
            del.icio.us logo Digg logo Reddit logo Technorati logo Twitter logo CiteULike logo Connotea logo Facebook logo Google logo Mendeley logo
            Full Text (PDF)

            Jump To

            • Article
              • Abstract
              • Abstract
              • Introduction
              • Methods
              • Results
              • Discussion
              • Supplementary material
              • Acknowledgements
              • Footnotes
              • References
            • Figures & Data
            • Info & Metrics
            • PDF

            Subjects

            • Respiratory infections and tuberculosis
            • Tweet Widget
            • Facebook Like
            • Google Plus One

            More in this TOC Section

            Original research articles

            • Role of small airway dysfunction in unexplained exertional dyspnoea
            • Patient attitudes to nebulised antibiotics in bronchiectasis
            • Acute health effects of heated tobacco products
            Show more Original research articles

            COVID-19

            • Inspiratory muscle strength/function in COVID-19 survivors
            • cDPP3, bio-ADM and outcomes in critical COVID-19 patients
            Show more COVID-19

            Related Articles

            Navigate

            • Home
            • Current issue
            • Archive

            About ERJ Open Research

            • Editorial board
            • Journal information
            • Press
            • Permissions and reprints
            • Advertising

            The European Respiratory Society

            • Society home
            • myERS
            • Privacy policy
            • Accessibility

            ERS publications

            • European Respiratory Journal
            • ERJ Open Research
            • European Respiratory Review
            • Breathe
            • ERS books online
            • ERS Bookshop

            Help

            • Feedback

            For authors

            • Instructions for authors
            • Publication ethics and malpractice
            • Submit a manuscript

            For readers

            • Alerts
            • Subjects
            • RSS

            Subscriptions

            • Accessing the ERS publications

            Contact us

            European Respiratory Society
            442 Glossop Road
            Sheffield S10 2PX
            United Kingdom
            Tel: +44 114 2672860
            Email: journals@ersnet.org

            ISSN

            Online ISSN: 2312-0541

            Copyright © 2023 by the European Respiratory Society