Background

Since December 2019 the novel coronavirus disease 2019 (COVID-19) has been burdening all health systems worldwide. However, pulmonary and extrapulmonary sequelae of COVID-19 after recovery from the acute disease are unknown.

Material and methods

Hospitalized COVID-19 patients not requiring mechanical ventilation were included and followed 6 weeks after discharge. Body plethysmography, lung diffusion capacity (DLco), blood gas analysis (ABG), 6-min walk test (6MWT), echocardiography, and laboratory tests were performed. Quality of life (QoL), depression, and anxiety were assessed using validated questionnaires.

Results

33 patients with severe disease were included. Patients were discharged without prophylactic anticoagulation. At follow-up there were no thromboembolic complications in any patient. 11 patients (33%) had dyspnea, 11 (33%) had cough, and 15 (45%) suffered from symptoms of fatigue. Pulmonary function tests including ABG did not reveal any limitations (TLC: median=94% of predicted {IQR:85-105}; VC: 93% {78-101}; FEV1: 95% {72-103}; FEV1/FVC 79% {76-85}; PaO2: 72 mmHg {67-79}; PaCO2: 38 mmHg {35-38}), except for slightly reduced DLco (77% {69-95}). There were no echocardiographic impairments. 6MWT distance was reduced in most patients without oxygen desaturation. According to standardized questionnaires, patients suffered from reduced QoL, mainly due to decreased mobility (SGRQ activity score: 54 {19-78}). There were no indicators for depression or anxiety (PHQ-9: 7 {4-11}, GAD-7: 4 {1-9}, respectively).

Conclusions

Hospitalized patients with severe COVID-19, who did not require mechanical ventilation, are unlikely to develop pulmonary long-term impairments, thromboembolic complications or cardiac impairments after discharge but frequently suffer from symptoms of fatigue.

中文翻译：

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2019 年重症冠状病毒病 (COVID-19) 患者的随访：肺和肺外疾病后遗症

背景

自 2019 年 12 月以来，新型冠状病毒病 2019 (COVID-19) 一直给全球所有卫生系统带来负担。然而，从急性疾病中恢复后 COVID-19 的肺部和肺外后遗症尚不清楚。

材料与方法

包括不需要机械通气的住院 COVID-19 患者，并在出院后 6 周进行随访。进行了身体体积描记法、肺扩散能力 (DLco)、血气分析 (ABG)、6 分钟步行试验 (6MWT)、超声心动图和实验室检查。使用经过验证的问卷评估生活质量 (QoL)、抑郁和焦虑。

结果

纳入重症患者33例。患者出院时未进行预防性抗凝治疗。随访期间，所有患者均未出现血栓栓塞并发症。11 名患者（33%）有呼吸困难，11 名（33%）有咳嗽，15 名（45%）有疲劳症状。包括 ABG 在内的肺功能测试未显示任何限制（TLC：中位数 = 预测值的 94% {IQR:85-105}；VC：93% {78-101}；FEV1：95% {72-103}；FEV1/FVC 79% {76-85}；PaO2：72 mmHg {67-79}；PaCO2：38 mmHg {35-38}），但 DLco 略有降低（77% {69-95}）。没有超声心动图障碍。大多数没有氧饱和度降低的患者 6MWT 距离缩短。根据标准化问卷，患者生活质量下降，主要是由于活动能力下降（SGRQ 活动评分：54 {19-78}）。

结论

不需要机械通气的重症 COVID-19 住院患者在出院后不太可能出现肺部长期损伤、血栓栓塞并发症或心脏损伤，但经常出现疲劳症状。