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Analysis of Pulmonary and Physical Function Three Months After Discharge for Moderate to Severe COVID-19

Received: 29 July 2021    Accepted: 11 August 2021    Published: 8 September 2021
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Abstract

Pulmonary fibrosis with persistent physiological deficit is a previously described feature of patients recovering from coronaviruses. Long-term health consequences of COVID-19 are still largely unknown. We aimed to evaluate whether CT abnormalities persist in COVID-19 survivors three months after discharge, and whether the amount of affected lung tissue correlates with pulmonary and physical function. Therefore, we evaluated patients three months after discharge at our outpatient clinic. All patients underwent pulmonary function testing, high resolution chest CT, six-minute walk test and handgrip strength test. We compared severely ill patients to moderately ill patients, whom respectively received treatment at the Intensive Care Unit and the general ward. In total 84 patients were included with a median age of 61·4±12·9 years of whom 53 were male. 50 patients had moderate disease and 34 were severely ill. 66 patients had residual abnormalities on follow-up chest CT. Reticulation and curvilinear bands were more frequent in severely ill patients (resp. 21% vs 4%; p=0·029 and 55% vs 23%; p=0·004). DLCOc, FEV1 and FVC in percentage of predicted were lower in severely ill patients. Severely ill patients were more likely to show an abnormal 6MWT, lower HGS and lower self-reported ADL and condition. In conclusion, in patients recovering from COVID-19, residual abnormalities were frequently present three months after hospitalization and associated with impaired pulmonary and physical function. This association was even stronger in patients who had been admitted to the ICU.

Published in Journal of Health and Environmental Research (Volume 7, Issue 3)
DOI 10.11648/j.jher.20210703.15
Page(s) 145-153
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

COVID-19, Long-COVID, Multidisciplinary Follow-up, Outpatient Clinic, Pulmonary Function

References
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Cite This Article
  • APA Style

    Bas Floris Maria Van Raaij, Jordy Lauran Stöger, Maarten Sebastiaan Werkman, Michiel Alexander De Graaf, Maria Louisa Antoni, et al. (2021). Analysis of Pulmonary and Physical Function Three Months After Discharge for Moderate to Severe COVID-19. Journal of Health and Environmental Research, 7(3), 145-153. https://doi.org/10.11648/j.jher.20210703.15

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    ACS Style

    Bas Floris Maria Van Raaij; Jordy Lauran Stöger; Maarten Sebastiaan Werkman; Michiel Alexander De Graaf; Maria Louisa Antoni, et al. Analysis of Pulmonary and Physical Function Three Months After Discharge for Moderate to Severe COVID-19. J. Health Environ. Res. 2021, 7(3), 145-153. doi: 10.11648/j.jher.20210703.15

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    AMA Style

    Bas Floris Maria Van Raaij, Jordy Lauran Stöger, Maarten Sebastiaan Werkman, Michiel Alexander De Graaf, Maria Louisa Antoni, et al. Analysis of Pulmonary and Physical Function Three Months After Discharge for Moderate to Severe COVID-19. J Health Environ Res. 2021;7(3):145-153. doi: 10.11648/j.jher.20210703.15

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  • @article{10.11648/j.jher.20210703.15,
      author = {Bas Floris Maria Van Raaij and Jordy Lauran Stöger and Maarten Sebastiaan Werkman and Michiel Alexander De Graaf and Maria Louisa Antoni and Geert Hendrik Groeneveld and Anna Helena Elvire Roukens and Frederikus Albertus Klok and Soerindra Rajen Soeniel Ramai and Jacomina Jessica Miranda Geelhoed},
      title = {Analysis of Pulmonary and Physical Function Three Months After Discharge for Moderate to Severe COVID-19},
      journal = {Journal of Health and Environmental Research},
      volume = {7},
      number = {3},
      pages = {145-153},
      doi = {10.11648/j.jher.20210703.15},
      url = {https://doi.org/10.11648/j.jher.20210703.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jher.20210703.15},
      abstract = {Pulmonary fibrosis with persistent physiological deficit is a previously described feature of patients recovering from coronaviruses. Long-term health consequences of COVID-19 are still largely unknown. We aimed to evaluate whether CT abnormalities persist in COVID-19 survivors three months after discharge, and whether the amount of affected lung tissue correlates with pulmonary and physical function. Therefore, we evaluated patients three months after discharge at our outpatient clinic. All patients underwent pulmonary function testing, high resolution chest CT, six-minute walk test and handgrip strength test. We compared severely ill patients to moderately ill patients, whom respectively received treatment at the Intensive Care Unit and the general ward. In total 84 patients were included with a median age of 61·4±12·9 years of whom 53 were male. 50 patients had moderate disease and 34 were severely ill. 66 patients had residual abnormalities on follow-up chest CT. Reticulation and curvilinear bands were more frequent in severely ill patients (resp. 21% vs 4%; p=0·029 and 55% vs 23%; p=0·004). DLCOc, FEV1 and FVC in percentage of predicted were lower in severely ill patients. Severely ill patients were more likely to show an abnormal 6MWT, lower HGS and lower self-reported ADL and condition. In conclusion, in patients recovering from COVID-19, residual abnormalities were frequently present three months after hospitalization and associated with impaired pulmonary and physical function. This association was even stronger in patients who had been admitted to the ICU.},
     year = {2021}
    }
    

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    AU  - Frederikus Albertus Klok
    AU  - Soerindra Rajen Soeniel Ramai
    AU  - Jacomina Jessica Miranda Geelhoed
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    AB  - Pulmonary fibrosis with persistent physiological deficit is a previously described feature of patients recovering from coronaviruses. Long-term health consequences of COVID-19 are still largely unknown. We aimed to evaluate whether CT abnormalities persist in COVID-19 survivors three months after discharge, and whether the amount of affected lung tissue correlates with pulmonary and physical function. Therefore, we evaluated patients three months after discharge at our outpatient clinic. All patients underwent pulmonary function testing, high resolution chest CT, six-minute walk test and handgrip strength test. We compared severely ill patients to moderately ill patients, whom respectively received treatment at the Intensive Care Unit and the general ward. In total 84 patients were included with a median age of 61·4±12·9 years of whom 53 were male. 50 patients had moderate disease and 34 were severely ill. 66 patients had residual abnormalities on follow-up chest CT. Reticulation and curvilinear bands were more frequent in severely ill patients (resp. 21% vs 4%; p=0·029 and 55% vs 23%; p=0·004). DLCOc, FEV1 and FVC in percentage of predicted were lower in severely ill patients. Severely ill patients were more likely to show an abnormal 6MWT, lower HGS and lower self-reported ADL and condition. In conclusion, in patients recovering from COVID-19, residual abnormalities were frequently present three months after hospitalization and associated with impaired pulmonary and physical function. This association was even stronger in patients who had been admitted to the ICU.
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Author Information
  • Department of Pulmonary Diseases, Leiden University Medical Center, Leiden, The Netherlands

  • Department of Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands

  • Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands

  • Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands

  • Department of Acute Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands

  • Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands

  • Department of Medicine-Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands

  • Department of Pulmonary Diseases, Leiden University Medical Center, Leiden, The Netherlands

  • Department of Pulmonary Diseases, Leiden University Medical Center, Leiden, The Netherlands

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