In a recent publication in the European Respiratory Journal, researchers discussed the findings from RE2COVERI (REspiratory REcovery after COVid-19 sevERe Infection), a prospective, multicenter, cohort study conducted in 13 French university and university-affiliated hospitals.

The study evaluated patients’ short-term, intermediate-term, and long-term trajectories of lung-function recovery after severe-to-critical COVID-19 infection and their determinants.

The prospective study was comprised of 485 adults who were previously hospitalized for severe COVID-19 infection (hospital length of stay ≥7 days and oxygen flow ≥3 L/min, including those managed with noninvasive ventilatory support without further invasive mechanical ventilation [IMV] required) or critical COVID-19 (IMV ≥48 hours). The average age of study participants was 60.7 years, and 73% were men.

The patients were categorized according to maximum disease severity during hospitalization based on the World Health Organization (WHO) clinical progression scale: WHO 5 patients (n = 173, 35.7%); WHO 6 patients (n = 96, 19.8%); and WHO 7 to 9 patients (n = 216, 44.5%).

Among the 485 enrolled participants, 293 (60%) were reevaluated at 6 months and 163 (35%) at 12 months; 89 (51%) and 47 (27%) of the 173 patients initially managed with standard oxygen were reevaluated at 6 and 12 months, respectively. At 3 months, 34%, 70%, and 56% of the participants had a restrictive lung defect, impaired diffusing capacity for carbon monoxide (DLCO), and significant radiological sequelae, respectively.

The value of DLCO and FVC (% of predicted value) were augmented by means of +4 points at 6 months and +6 points at 12 months during extended follow-up. Gender, BMI, chronic respiratory disease, immunosuppression, pneumonia extent or corticosteroid use during acute COVID-19, and prolonged invasive mechanical ventilation (IMV) were correlated with DLCO at Month 3 but not its trajectory after that. Among 475 (98%) patients with at least one chest CT scan during follow-up, 196 (41%) had significant sequelae in assessments within 1 year of discharge for severe-to-critical COVID-19 infection.

Based on their findings, the authors wrote, “Although pulmonary function and radiological abnormalities improved up to 1 year post-acute-COVID-19, high percentages of severe-to-critical disease survivors, including a notable proportion of those managed with standard oxygen, had significant lung sequelae and residual symptoms justifying prolonged follow-up.”

The authors concluded, “The results of this pragmatic, longitudinal study bring additional insights into the short-to-long-term respiratory recovery of severe-to-critical COVID-19 patients. Although most of the participants globally recovered, high percentages had radiological and functional sequelae and residual symptoms throughout follow-up, all of which might have affected their HR-QoL.”

Lastly, the authors indicated that their findings also emphasized the burdens of posthospital monitoring for such patients and their clinicians. They also supplied further suggestions on measures that need to be employed while monitoring patients with post–severe-to-critical COVID-19 infection.

The content contained in this article is for informational purposes only. The content is not intended to be a substitute for professional advice. Reliance on any information provided in this article is solely at your own risk.

 « Click here to return to Respiratory Update.