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Changes in pulmonary function and patient-reported outcomes during COVID-19 recovery: a longitudinal, prospective cohort study

Aditi S. Shah, Min Hyung Ryu, Cameron J Hague, Darra T. Murphy, James C. Johnston, Christopher J. Ryerson, Christopher Carlsten, Alyson W. Wong
ERJ Open Research 2021; DOI: 10.1183/23120541.00243-2021
Aditi S. Shah
1Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver General Hospital, Vancouver, Canada
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Min Hyung Ryu
1Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver General Hospital, Vancouver, Canada
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Cameron J Hague
2Department of Radiology, University of British Columbia, St. Paul's Hospital, Vancouver, Canada
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Darra T. Murphy
2Department of Radiology, University of British Columbia, St. Paul's Hospital, Vancouver, Canada
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James C. Johnston
3Division of Respiratory Medicine, Department of Medicine, University of British Columbia, BC Centre for Disease Control, Vancouver, Canada
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Christopher J. Ryerson
4Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, Canada
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Christopher Carlsten
1Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver General Hospital, Vancouver, Canada
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  • For correspondence: carlsten@mail.ubc.ca
Alyson W. Wong
4Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, Canada
5Co-senior authors
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Abstract

Objectives To compare respiratory and patient-reported outcome measures (PROMs) between 3 and 6 months after symptom onset and to identify features that predict these changes.

Methods This is a consecutive prospective cohort of 73 patients who were hospitalised with COVID-19. We evaluated the changes in pulmonary function tests (PFTs) and PROMs between 3 and 6 months and then investigated the associations between outcomes (change in diffusing capacity for carbon monoxide of the lung (DLCO), dyspnea, and quality of life (QOL)) and clinical and radiological features.

Results There was improvement in forced vital capacity (FVC), total lung capacity (TLC), and DLCO between 3 and 6 months by 3.25%, 3.82% and 5.69% respectively; however, there was no difference in PROMs. Reticulation and total CT scores were associated with lower DLCO %-predicted at 6 months (coefficients; −8.7 and −5.3 respectively). The association between radiological scores and DLCO were modified by time, with the degree of association between ground glass and DLCO having decreased markedly over time. There was no association between other predictors and change in dyspnea or QOL over time.

Conclusions There is improvement in pulmonary function measurements between 3 and 6 months after COVID-19 symptom onset; however, PROMs did not improve. A higher reticulation and total CT score are negatively associated with DLCO, but this association is attenuated over time. Lastly, there is a considerable proportion of patients with unexplained dyspnea at 6 months, motivating further research to identify the underlying mechanisms.

Footnotes

This manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.

Conflict of interest: Dr. Shah has nothing to disclose.

Conflict of interest: Mr. Ryu has nothing to disclose.

Conflict of interest: Dr. Hague has nothing to disclose.

Conflict of interest: Dr. Murphy has nothing to disclose.

Conflict of interest: Dr. Johnston has nothing to disclose.

Conflict of interest: Dr. Ryerson has nothing to disclose.

Conflict of interest: Dr. Carlsten has nothing to disclose.

Conflict of interest: Dr. Wong has nothing to disclose.

This is a PDF-only article. Please click on the PDF link above to read it.

  • Received April 7, 2021.
  • Accepted June 11, 2021.
  • Copyright ©The authors 2021
http://creativecommons.org/licenses/by-nc/4.0/

This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions{at}ersnet.org

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Changes in pulmonary function and patient-reported outcomes during COVID-19 recovery: a longitudinal, prospective cohort study
Aditi S. Shah, Min Hyung Ryu, Cameron J Hague, Darra T. Murphy, James C. Johnston, Christopher J. Ryerson, Christopher Carlsten, Alyson W. Wong
ERJ Open Research Jan 2021, 00243-2021; DOI: 10.1183/23120541.00243-2021

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Changes in pulmonary function and patient-reported outcomes during COVID-19 recovery: a longitudinal, prospective cohort study
Aditi S. Shah, Min Hyung Ryu, Cameron J Hague, Darra T. Murphy, James C. Johnston, Christopher J. Ryerson, Christopher Carlsten, Alyson W. Wong
ERJ Open Research Jan 2021, 00243-2021; DOI: 10.1183/23120541.00243-2021
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