Long-term impact of COVID-19 hospitalisation among individuals with pre-existing airways diseases in the UK: a multicentre, longitudinal cohort study (PHOSP-COVID)

Abstract

BackgroundThe long-term outcomes of COVID-19 hospitalisation in individuals with pre-existing airways diseases are unknown.MethodsAdult participants hospitalised for confirmed or clinically suspected COVID-19 and discharged between 5 March 2020 and 31 March 2021 were recruited to the Post-hospitalisation COVID-19 (PHOSP-COVID) study. Participants attended research visits at five-months and one-year post discharge. Clinical characteristics, perceived recovery, burden of symptoms and health related quality of life (HRQoL) of individuals with pre-existing airways disease (i.e., asthma, chronic obstructive pulmonary disease (COPD) or bronchiectasis) were compared to the non-airways group.ResultsA total of 615/2697 (22.8%) participants had a history of pre-existing airways diseases (72.0% diagnosed with asthma, 22.9% COPD and 5.1% bronchiectasis). At one-year, the airways group participants were less likely to feel fully recovered (20.4%versus33.2%, p<0.001), had higher burden of anxiety (29.1%versus22.0%, p=0.002), depression (31.2%versus24.7%, p=0.006), higher percentage of impaired mobility using Short Physical Performance Battery ≤10 (57.4%versus45.2%, p<0.001) and 27% had a new disability (assessed by the Washington Group Short Set on Functioning)versus16.6%, p=0.014. HRQoL assessed using EQ-5D-5 L Utility Index was lower in the airways group (0.64 (sd0.27)versus0.73 (sd0.25), p<0.001). Burden of breathlessness, fatigue and cough measured using a study specific tool was higher in the airways group.ConclusionIndividuals with pre-existing airways diseases hospitalised due to COVID-19 were less likely to feel fully recovered, had lower physiological performance measurements, more burden of symptoms and reduced HRQoL up to one-year post hospital discharge.