Author:
Chan Ken Ka Pang,Ng Susanna So Shan,Lui Grace Chung Yan,Leung Ho Sang,Wong Ka Tak,Chu Winnie Chiu Wing,Chan Tat On,Yiu Karen Yee Shan,Tso Eugene Yuk Keung,To Kin Wang,Ngai Jenny Chun Li,Yip Tommy Wing Ho,Lo Rachel Lai Ping,Ng Joyce Ka Ching,Ko Fanny Wai San,Hui David Shu Cheong
Abstract
Abstract
Background
Little is known about the differences in medium to long-term recovery on spirometry, 6-minute walking distance (6MWD) and health-related quality of life (HRQoL) between COVID-19 and SARS.
Methods
We performed a 12-month prospective study on COVID-19 survivors. The changes in dynamic lung volumes at spirometry (%predicted FEV1, %predicted FVC), 6MWD and HRQoL at 1–3, 6 to 12 months were compared against a historical cohort of SARS survivors using the same study protocol. The residual radiological changes in HRCT in COVID-19 survivors were correlated with their functional capacity.
Results
108 COVID-19 survivors of various disease severity (asymptomatic 2.9%, mild 33.3%, moderate 47.2%, severe 8.3%, critical 8.3%) were recruited. When compared with 97 SARS survivors, 108 COVID-19 survivors were older (48.1 ± 16.4 vs. 36.1 ± 9.5 years, p < 0.001) and required less additional support during hospitalization; with lower dynamic lung volumes, shorter 6MWD and better physical component score. Both groups of survivors had comparable changes in these parameters at subsequent follow-ups. Both COVID-19 and SARS survivors had similar mental component score (MCS) at 6 and 12 months. COVID-19 survivors initially experienced less (between-group difference, -3.1, 95% confidence interval [CI] -5.5 to -0.7, p = 0.012) and then more improvement (between-group difference 2.9, 95%, CI 0.8 to 5.1, p = 0.007) than SARS survivors in the MCS at 1–3 to 6 months and 6 to 12 months respectively. Forty (44.0%) out of 91 COVID-19 survivors had residual abnormalities on HRCT at 12 months, with a negative correlation between the severity scores of parenchymal changes and 6MWD (r=-0.239, p < 0.05).
Conclusions
COVID-19 survivors demonstrated a similar recovery speed in dynamic lung volumes and exercise capacity, but different paces of psychological recovery as SARS survivors in the convalescent phase. The severity of parenchymal changes in HRCT is negatively correlated with the 6MWD of COVID-19 survivors.
Trial registration
This prospective study was registered at ClinicalTrials.gov on 2 November 2020 (Identifier: NCT04611243).
Funder
Health and Medical Research Fund Commissioned Research on the Novel Coronavirus Disease (COVID-19), Hong Kong SAR
RGC theme-based research schemes
RMG Kai Chong Tong
SH Ho Foundation
Publisher
Springer Science and Business Media LLC
Subject
Pulmonary and Respiratory Medicine
Reference48 articles.
1. WHO Coronavirus (COVID-19) Dashboard. World Health Organization. https://covid19.who.int/?adgroupsurvey={adgroupsurvey}&gclid=Cj0KCQjwr4eYBhDrARIsANPywCjfekv7dkHdZ6IwpwelpVAOyNT9n8cjPLGW47OL_PqcoHWcW2je4IsaAv6dEALw_wcB. Date accessed: 25 August 2023.
2. Centre for Health Protection, Department of Health, The Government of the Hong Kong Special Administrative Region. Latest situation of cases of COVID-19. https://chp-dashboard.geodata.gov.hk/covid-19/en.html. Date accessed: 12 April 2023.
3. Huang L, Yao Q, Gu X, Wang Q, Ren L, Wang Y, et al. 1-year outcomes in hospital survivors with COVID-19: a longitudinal cohort study. Lancet. 2021;398(10302):747–58.
4. Trinkmann F, Müller M, Reif A, Kahn N, Kreuter M, Trudzinski F, et al. Residual symptoms and lower lung function in patients recovering from SARS-CoV-2 Infection. Eur Respir J. 2021;57(2):2003002.
5. Wu X, Liu X, Zhou Y, Yu H, Li R, Zhan Q, et al. 3-month, 6-month, 9-month, and 12-month respiratory outcomes in patients following COVID-19-related hospitalisation: a prospective study. Lancet Respir Med. 2021;9(7):747–54.