tetano
Editor, Senior Moderator
ERJ Open Res
. 2022 Apr 19;8(2):00479-2021.
doi: 10.1183/23120541.00479-2021. eCollection 2022 Apr.
Respiratory symptoms and radiological findings in post-acute COVID-19 syndrome
Etienne-Marie Jutant[SUP] 1 2 3 [/SUP], Olivier Meyrignac[SUP] 1 4 [/SUP], Antoine Beurnier[SUP] 1 2 5 [/SUP], Xavier Jaïs[SUP] 1 2 3 [/SUP], Tai Pham[SUP] 1 6 [/SUP], Luc Morin[SUP] 1 7 [/SUP], Athénaïs Boucly[SUP] 1 2 3 [/SUP], Sophie Bulifon[SUP] 1 2 3 [/SUP], Samy Figueiredo[SUP] 1 8 [/SUP], Anatole Harrois[SUP] 1 8 [/SUP], Mitja Jevnikar[SUP] 1 2 3 [/SUP], Nicolas Noël[SUP] 1 9 [/SUP], Jérémie Pichon[SUP] 1 2 3 [/SUP], Anne Roche[SUP] 1 2 3 [/SUP], Andrei Seferian[SUP] 1 2 3 [/SUP], Samer Soliman[SUP] 1 4 [/SUP], Jacques Duranteau[SUP] 1 8 [/SUP], Laurent Becquemont[SUP] 1 10 [/SUP], Xavier Monnet[SUP] 1 6 [/SUP], Olivier Sitbon[SUP] 1 2 3 [/SUP], Marie-France Bellin[SUP] 1 4 [/SUP], Marc Humbert[SUP] 1 2 3 [/SUP], Laurent Savale[SUP] 1 2 3 11 [/SUP], David Montani[SUP] 1 2 3 11 [/SUP]
Affiliations
Abstract
Rationale: The characteristics of patients with respiratory complaints and/or lung radiologic abnormalities after hospitalisation for coronavirus disease 2019 (COVID-19) are unknown. The objectives were to determine their characteristics and the relationships between dyspnoea, radiologic abnormalities and functional impairment.
Methods: In the COMEBAC (Consultation Multi-Expertise de Bicêtre Après COVID-19) cohort study, 478 hospital survivors were evaluated by telephone 4 months after hospital discharge, and 177 who had been hospitalised in an intensive care unit (ICU) or presented relevant symptoms underwent an ambulatory evaluation. New-onset dyspnoea and cough were evaluated, and the results of pulmonary function tests and high-resolution computed tomography of the chest were collected.
Results: Among the 478 patients, 78 (16.3%) reported new-onset dyspnoea, and 23 (4.8%) new-onset cough. The patients with new-onset dyspnoea were younger (56.1±12.3 versus 61.9±16.6 years), had more severe COVID-19 (ICU admission 56.4% versus 24.5%) and more frequent pulmonary embolism (18.0% versus 6.8%) (all p≤0.001) than patients without dyspnoea. Among the patients reassessed at the ambulatory care visit, the prevalence of fibrotic lung lesions was 19.3%, with extent <25% in 97% of the patients. The patients with fibrotic lesions were older (61±11 versus 56±14 years, p=0.03), more frequently managed in an ICU (87.9 versus 47.4%, p<0.001), had lower total lung capacity (74.1±13.7 versus 84.9±14.8% pred, p<0.001) and diffusing capacity of the lung for carbon monoxide (D [SUB]LCO[/SUB]) (73.3±17.9 versus 89.7±22.8% pred, p<0.001). The combination of new-onset dyspnoea, fibrotic lesions and D [SUB]LCO[/SUB] <70% pred was observed in eight out of 478 patients.
Conclusions: New-onset dyspnoea and mild fibrotic lesions were frequent at 4 months, but the association of new-onset dyspnoea, fibrotic lesions and low D [SUB]LCO[/SUB] was rare.
. 2022 Apr 19;8(2):00479-2021.
doi: 10.1183/23120541.00479-2021. eCollection 2022 Apr.
Respiratory symptoms and radiological findings in post-acute COVID-19 syndrome
Etienne-Marie Jutant[SUP] 1 2 3 [/SUP], Olivier Meyrignac[SUP] 1 4 [/SUP], Antoine Beurnier[SUP] 1 2 5 [/SUP], Xavier Jaïs[SUP] 1 2 3 [/SUP], Tai Pham[SUP] 1 6 [/SUP], Luc Morin[SUP] 1 7 [/SUP], Athénaïs Boucly[SUP] 1 2 3 [/SUP], Sophie Bulifon[SUP] 1 2 3 [/SUP], Samy Figueiredo[SUP] 1 8 [/SUP], Anatole Harrois[SUP] 1 8 [/SUP], Mitja Jevnikar[SUP] 1 2 3 [/SUP], Nicolas Noël[SUP] 1 9 [/SUP], Jérémie Pichon[SUP] 1 2 3 [/SUP], Anne Roche[SUP] 1 2 3 [/SUP], Andrei Seferian[SUP] 1 2 3 [/SUP], Samer Soliman[SUP] 1 4 [/SUP], Jacques Duranteau[SUP] 1 8 [/SUP], Laurent Becquemont[SUP] 1 10 [/SUP], Xavier Monnet[SUP] 1 6 [/SUP], Olivier Sitbon[SUP] 1 2 3 [/SUP], Marie-France Bellin[SUP] 1 4 [/SUP], Marc Humbert[SUP] 1 2 3 [/SUP], Laurent Savale[SUP] 1 2 3 11 [/SUP], David Montani[SUP] 1 2 3 11 [/SUP]
Affiliations
- PMID: 35445129
- PMCID: PMC8685862
- DOI: 10.1183/23120541.00479-2021
Abstract
Rationale: The characteristics of patients with respiratory complaints and/or lung radiologic abnormalities after hospitalisation for coronavirus disease 2019 (COVID-19) are unknown. The objectives were to determine their characteristics and the relationships between dyspnoea, radiologic abnormalities and functional impairment.
Methods: In the COMEBAC (Consultation Multi-Expertise de Bicêtre Après COVID-19) cohort study, 478 hospital survivors were evaluated by telephone 4 months after hospital discharge, and 177 who had been hospitalised in an intensive care unit (ICU) or presented relevant symptoms underwent an ambulatory evaluation. New-onset dyspnoea and cough were evaluated, and the results of pulmonary function tests and high-resolution computed tomography of the chest were collected.
Results: Among the 478 patients, 78 (16.3%) reported new-onset dyspnoea, and 23 (4.8%) new-onset cough. The patients with new-onset dyspnoea were younger (56.1±12.3 versus 61.9±16.6 years), had more severe COVID-19 (ICU admission 56.4% versus 24.5%) and more frequent pulmonary embolism (18.0% versus 6.8%) (all p≤0.001) than patients without dyspnoea. Among the patients reassessed at the ambulatory care visit, the prevalence of fibrotic lung lesions was 19.3%, with extent <25% in 97% of the patients. The patients with fibrotic lesions were older (61±11 versus 56±14 years, p=0.03), more frequently managed in an ICU (87.9 versus 47.4%, p<0.001), had lower total lung capacity (74.1±13.7 versus 84.9±14.8% pred, p<0.001) and diffusing capacity of the lung for carbon monoxide (D [SUB]LCO[/SUB]) (73.3±17.9 versus 89.7±22.8% pred, p<0.001). The combination of new-onset dyspnoea, fibrotic lesions and D [SUB]LCO[/SUB] <70% pred was observed in eight out of 478 patients.
Conclusions: New-onset dyspnoea and mild fibrotic lesions were frequent at 4 months, but the association of new-onset dyspnoea, fibrotic lesions and low D [SUB]LCO[/SUB] was rare.