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

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.