Longitudinal Assessment of Health and Quality of Life of COVID-19 Patients Requiring Intensive Care-An Observational Study.

Johanna Erber,Rickmer Braren,Johannes R Wießner,Jochen Schneider,Fabian Lohöfer,Petra Barthel,Sebastian Rasch,Gregor S Zimmermann,Christoph D Spinner,Egon Burian,Tobias Lahmer,Eimo Martens,Roland M Schmid,Hrvoje Mijočević

doi:10.3390/jcm10235469

Johanna Erber, Rickmer Braren + Show 12 more

Open Access

https://doi.org/10.3390/jcm10235469

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Abstract

Long-term health consequences in survivors of severe COVID-19 remain unclear. Eighteen COVID-19 patients admitted to the intensive care unit at the University Hospital Rechts der Isar, Munich, Germany, between 14 March and 23 June 2020, were prospectively followed-up at a median of 36, 75.5, 122 and 222 days after discharge. The health-related quality of life (HrQoL) (36-item Short Form Health Survey and St. George’s Respiratory Questionnaire, SGRQ), cardiopulmonary function, laboratory parameters and chest imaging were assessed longitudinally. The HrQoL assessment revealed a reduced physical functioning, as well as increased SGRQ impact and symptoms scores that all improved over time but remained markedly impaired compared to the reference groups. The median radiological severity scores significantly declined; persistent abnormalities were found in 33.3% of the patients on follow-up. A reduced diffusion capacity was the most common abnormal pulmonary function parameter. The length of hospitalization correlated with role limitations due to physical problems, the SGRQ symptom and the impact score. In conclusion, in survivors of severe COVID-19, the pulmonary function and symptoms improve over time, but impairments in their physical function and diffusion capacity can persist over months. Longer follow-up studies with larger cohorts will be necessary to comprehensively characterize long-term sequelae upon severe COVID-19 and to identify patients at risk.

Highlights

IntroductionData from survivors of previous viral outbreaks, such as SARS and the Middle East respiratory syndrome coronavirus (MERS), show that pulmonary, as well as physical and mental function, may be impaired for months after discharge [1]
While the global population of individuals recovering from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is growing as the virus spreads throughout continents, reports on persisting physical and mental health impairments are emerging, raising concerns about a potentially impeding chronic health issue
All 18 eligible patients had been admitted to the ICU due to respiratory failure

Summary

Introduction

Data from survivors of previous viral outbreaks, such as SARS and the Middle East respiratory syndrome coronavirus (MERS), show that pulmonary, as well as physical and mental function, may be impaired for months after discharge [1]. Whereas both the pulmonary function and radiological abnormalities seem to improve within the first years of recovery, residual pulmonary lesions and the persistent impairment of lung diffusion capacity have been described even 15 years after SARS infection [2].

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