How Is Life After Severe COVID-19?

Abstract

Background

Data on long-term outcomes of COVID-19-related ARDS are scarce and rely largely on patient-reported outcomes. This study aimed to study cardiopulmonary function combined with psychosocial sequelae in a cohort of patients with severe COVID-19 requiring ICU management and intubation, with a follow-up of 12 months.

Research Question

What are the functional and psychosocial sequelae 1 year after severe COVID-19 requiring ICU management and intubation?

Study Design and Methods

We studied a longitudinal cohort of 39 mechanically ventilated patients with COVID-19 from the early phase of the pandemic. Pulmonary function test results, cardiopulmonary exercise testing findings, and subjective health perception data from 6 and 12 months after ICU admission were collected.

Results

Twelve months after COVID-19, 19.3% of participants showed at least moderate alteration in pulmonary function test findings, and 35.7% of participants showed a pathologically reduced effort capacity by cardiopulmonary exercise testing. A considerable impact on daily activities was reported, with only 41.7% of participants being able to resume work entirely and 71% reporting a relevant health impairment resulting from residual respiratory symptoms. The health perception scores did not correlate significantly with the measured cardiopulmonary performance or lung function.

Interpretation

A persistent objective limitation in physical activity was observed in this population of unvaccinated patients from the early phase of the pandemic, studied for 12 months after recovery from COVID-19-related ARDS. Patients also reported a profound impact on functional autonomy, daily activities, professional life, and health perception. Despite being attributed primarily to residual respiratory symptoms, the observed health impairment is probably multifactorial, with physical and psychological factors playing a role. The prolonged course of the symptoms and the underlying complexity should be considered in future programs for the care of patients who have recovered from COVID-19.