Cardiopulmonary recovery after COVID-19 – an observational prospective multi-center trial

Sonnweber, Thomas; Sahanic, Sabina; Pizzini, Alex; Luger, Anna; Schwabl, Christoph; Sonnweber, Bettina; Kurz, Katharina; Koppelstätter, Sabine; Haschka, David; Petzer, Verena; Boehm, Anna; Aichner, Magdalena; Tymoszuk, Piotr; Lener, Daniela; Theurl, Markus; Lorsbach-Köhler, Almut; Tancevski, Amra; Schapfl, Anna; Schaber, Marc; Hilbe, Richard; Nairz, Manfred; Puchner, Bernhard; Hüttenberger, Doris; Tschurtschenthaler, Christoph; Aßhoff, Malte; Peer, Andreas; Hartig, Frank; Bellmann, Romuald; Joannidis, Michael; Gollmann-Tepeköylü, Can; Holfeld, Johannes; Feuchtner, Gudrun; Egger, Alexander; Hoermann, Gregor; Schroll, Andrea; Fritsche, Gernot; Wildner, Sophie; Bellmann-Weiler, Rosa; Kirchmair, Rudolf; Helbok, Raimund; Prosch, Helmut; Rieder, Dietmar; Trajanoski, Zlatko; Kronenberg, Florian; Wöll, Ewald; Weiss, Günter; Widmann, Gerlig; Löffler-Ragg, Judith; Tancevski, Ivan

BACKGROUND: After the 2002/2003 SARS outbreak, 30% of survivors exhibited persisting structural pulmonary abnormalities. The long-term pulmonary sequelae of coronavirus disease 2019 (COVID-19) are yet unknown, and comprehensive clinical follow-up data are lacking. METHODS: In this prospective, multicentre, observational study, we systematically evaluated the cardiopulmonary damage in subjects recovering from COVID-19 at 60 and 100 days after confirmed diagnosis. We conducted a detailed questionnaire, clinical examination, laboratory testing, lung function analysis, echocardiography, and thoracic low-dose computed tomography (CT). RESULTS: Data from 145 COVID-19 patients were evaluated, and 41% of all subjects exhibited persistent symptoms 100 days after COVID-19 onset, with dyspnea being most frequent (36%). Accordingly, patients still displayed an impaired lung function, with a reduced diffusing capacity in 21% of the cohort being the most prominent finding. Cardiac impairment, including a reduced left ventricular function or signs of pulmonary hypertension, was only present in a minority of subjects. CT scans unveiled persisting lung pathologies in 63% of patients, mainly consisting of bilateral ground-glass opacities and/or reticulation in the lower lung lobes, without radiological signs of pulmonary fibrosis. Sequential follow-up evaluations at 60 and 100 days after COVID-19 onset demonstrated a vast improvement of both, symptoms and CT abnormalities over time. CONCLUSION: A relevant percentage of post-COVID-19 patients presented with persisting symptoms and lung function impairment along with pulmonary abnormalities more than 100 days after the diagnosis of COVID-19. However, our results indicate a significant improvement in symptoms and cardiopulmonary status over time.