How Is Life After Severe COVID-19?: Functional Cardiopulmonary Outcome and Quality of Life

Abstract

BACKGROUND AND AIMData on long-term outcomes of COVID19-related acute respiratory distress syndrome (ARDS) are scarce and repose mostly on patients reported outcomes. This study aimed to study cardiopulmonary functions combined with psychosocial sequels in a cohort of severe COVID-19 patients requiring intensive care unit (ICU) management and intubation, with a follow-up of 12 months. DESIGN AND METHODSWe studied a longitudinal cohort of 39 mechanically ventilated COVID-19 patients from the early pandemic phase. Pulmonary function tests (PFT), cardiopulmonary exercise testing (CPET), and subjective health perception data 6 and 12 months after ICU admission were collected. RESULTSTwelve months after COVID-19, 19.3% of the participants showed at least moderate alteration in PFT, and 35.7% a pathologically reduced effort capacity by CPET. A considerable impact on daily activities was reported, with only 41.7% being able to entirely resume work and 71% reporting a relevant health impairment due to residual respiratory symptoms. The health perception scores did not correlate significantly with the measured cardiopulmonary performance or lung function. CONCLUSIONSA persistent objective limitation in physical activity was observed in this population of unvaccinated patients from the early pandemic phase, studied for 12 months after COVID19-related ARDS. Patients also reported a profound impact on functional autonomy, daily activities, professional life, and health perception. Despite being primarily attributed to residual respiratory symptoms, the observed health impairment is probably multifactorial, with physical and psychological factors playing a role.The prolonged course of the symptoms and the underlying complexity should be considered in future programs for the care of post-COVID patients.