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One-Fourth of COVID-19 Patients Have an Impaired Pulmonary Function after 12 Months of Illness Onset

21 Pages Posted: 24 Feb 2023

See all articles by Hugo D.G. van Willigen

Hugo D.G. van Willigen

Amsterdam University Medical Centre, University of Amsterdam - Department of Medical Microbiology and Infection Prevention

Elke Wynberg

Amsterdam University Medical Centre, University of Amsterdam - Department of Medical Microbiology and Infection Prevention

Anouk Verveen

University of Amsterdam - Amsterdam Public Health Research Institute

Maartje Dijkstra

Public Health Service of Amsterdam - Department of Infectious Diseases

Bas J. Verkaik

University of Amsterdam - Amsterdam Institute for Infection and Immunity

Orlane J.A. Figaroa

University of Amsterdam - Amsterdam Institute for Infection and Immunity

Marianne C. de Jong

Public Health Service of Amsterdam - Department of Infectious Diseases

Annelou van Veen

University of Amsterdam - Department of Infectious Diseases

Agata Makowska

Public Health Service of Amsterdam - Department of Infectious Diseases

Nelleke Koedoot

Public Health Service of Amsterdam - Department of Infectious Diseases

Pythia T. Nieuwkerk

University of Amsterdam - Medical Psychology

Anders Boyd

Public Health Service of Amsterdam - Department of Infectious Diseases

Maria Prins

Public Health Service of Amsterdam - Department of Infectious Diseases

Godelieve J. de Bree

University of Amsterdam - Amsterdam Public Health Research Institute

Menno D. de Jong

University of Amsterdam - Department of Medical Microbiology and Infection Prevention

Joost G. van den Aardweg

University of Amsterdam - Department of Pulmonary Medicine

More...

Abstract

Background: This longitudinal study evaluates the extent of impaired pulmonary function over time after SARS-CoV-2 infection across the full spectrum of COVID-19 severity.

Methods: Pulmonary function was measured by diffusing capacity for carbon monoxide (DLCO) at one, six, and twelve months after illness onset. Additionally, data on sociodemographics, clinical characteristics, symptoms, and health-related quality of life (HRQL) were collected. Pulmonary function and determinants were modelled over time using mixed-effect linear regression. Determinants of pulmonary impairment at 12 months since illness onset were identified using logistic regression.

Findings: Between May 2020 and December 2021, 301 of 349 participants underwent at least one pulmonary function test. After one year of follow-up, 25% of the participants had an impaired pulmonary function which translates in 11%, 22%, and 48% of the participants with mild, moderate and severe/critical COVID-19. Improvement in DLCO among the participants continued over the period across one, six and twelve months. Having more than three comorbidities (p<0·001) and initial severe/critical illness (p<0·001) were associated with slower improvement of pulmonary function over time, adjusted for age and sex. HRQL improved over time and was not different to those without impaired pulmonary function.

Interpretation: The prevalence of impaired pulmonary function after twelve months of follow-up, was still significant among those with initially moderate or severe/critical COVID-19. However, those who continued to have impaired pulmonary function after one year did not have impaired HRQL.

Funding: This work was supported by the Netherlands Organization for Health Research and Development (ZonMw) [10150062010002 to M.D.d.J.] and the Public Health Service of Amsterdam [R&D in 2021 and 2022 to M.P.].

Declaration of Interest: All authors declare no competing interests.

Ethical Approval: Written informed consent was obtained from each study participant. The study design was approved by the local ethics committee of the Amsterdam UMC (Medisch Ethische Toetsingscommissie [METC]; NL73759.018.20).

Keywords: COVID-19, pulmonary function, HRQL, post-acute sequelae, long COVID

Suggested Citation

van Willigen, Hugo D.G. and Wynberg, Elke and Verveen, Anouk and Dijkstra, Maartje and Verkaik, Bas J. and Figaroa, Orlane J.A. and de Jong, Marianne C. and van Veen, Annelou and Makowska, Agata and Koedoot, Nelleke and Nieuwkerk, Pythia T. and Boyd, Anders and Prins, Maria and de Bree, Godelieve J. and de Jong, Menno D. and Aardweg, Joost G. van den, One-Fourth of COVID-19 Patients Have an Impaired Pulmonary Function after 12 Months of Illness Onset. Available at SSRN: https://ssrn.com/abstract=4366836 or http://dx.doi.org/10.2139/ssrn.4366836

Hugo D.G. Van Willigen (Contact Author)

Amsterdam University Medical Centre, University of Amsterdam - Department of Medical Microbiology and Infection Prevention ( email )

United States

Elke Wynberg

Amsterdam University Medical Centre, University of Amsterdam - Department of Medical Microbiology and Infection Prevention ( email )

Anouk Verveen

University of Amsterdam - Amsterdam Public Health Research Institute ( email )

Meibergdreef 9
Amsterdam, 1105
Netherlands

Maartje Dijkstra

Public Health Service of Amsterdam - Department of Infectious Diseases ( email )

Bas J. Verkaik

University of Amsterdam - Amsterdam Institute for Infection and Immunity ( email )

Orlane J.A. Figaroa

University of Amsterdam - Amsterdam Institute for Infection and Immunity ( email )

Marianne C. De Jong

Public Health Service of Amsterdam - Department of Infectious Diseases ( email )

Annelou Van Veen

University of Amsterdam - Department of Infectious Diseases ( email )

Netherlands

Agata Makowska

Public Health Service of Amsterdam - Department of Infectious Diseases ( email )

Nelleke Koedoot

Public Health Service of Amsterdam - Department of Infectious Diseases ( email )

Pythia T. Nieuwkerk

University of Amsterdam - Medical Psychology ( email )

Anders Boyd

Public Health Service of Amsterdam - Department of Infectious Diseases ( email )

Maria Prins

Public Health Service of Amsterdam - Department of Infectious Diseases ( email )

Godelieve J. De Bree

University of Amsterdam - Amsterdam Public Health Research Institute ( email )

Meibergdreef 9
Amsterdam, 1105
Netherlands

Menno D. De Jong

University of Amsterdam - Department of Medical Microbiology and Infection Prevention ( email )

Amsterdam
Netherlands

Joost G. van den Aardweg

University of Amsterdam - Department of Pulmonary Medicine

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