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Article Dans Une Revue European Respiratory Journal Année : 2023

Respiratory recovery trajectories after severe-to-critical COVID-19: a 1-year prospective multicentre study

1 Hôpital Henri Mondor
2 IMRB - Institut Mondor de Recherche Biomédicale
3 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
4 DCAC - Défaillance Cardiovasculaire Aiguë et Chronique
5 CEReSS - Centre d'études et de recherche sur les services de santé et la qualité de vie
6 Hôpitaux Sud - Département Universitaire de Psychiatrie - [Hôpital Sainte Marguerite - APHM]
7 AP-HP - Hopital Saint-Louis [AP-HP]
8 CHU Tenon [AP-HP]
9 HUG - Hôpitaux Universitaires de Genève
10 CHU Amiens-Picardie
11 AGIR - Agents infectieux, résistance et chimiothérapie - UR UPJV 4294
12 UPJV - Université de Picardie Jules Verne
13 Service de Pneumologie [CHI Créteil]
14 CEpiA - Clinical Epidemiology and Ageing : Geriatrie Soins Primaires et Santé Publique
15 CRC (UMR_S_1138 / U1138) - Centre de Recherche des Cordeliers
16 IAME (UMR_S_1137 / U1137) - Infection, Anti-microbiens, Modélisation, Evolution
17 CHV - Centre Hospitalier de Versailles André Mignot
18 HEGP - Hôpital Européen Georges Pompidou [APHP]
19 Hôpital Avicenne [AP-HP]
20 H&P - U1272 Inserm - Hypoxie et Poumon : pneumopathologies fibrosantes, modulations ventilatoires et circulatoires
21 CHU Pitié-Salpêtrière [AP-HP]
22 UMRS 1158 - Neurophysiologie Respiratoire Expérimentale et Clinique
23 CRCTB - Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux]
24 Hôpital Haut-Lévêque [CHU Bordeaux]
25 BPH - Bordeaux population health
26 Centre Hospitalier de Basse-Terre [Guadeloupe]
27 Hôpital Ambroise Paré [AP-HP]
28 UVSQ - Université de Versailles Saint-Quentin-en-Yvelines
29 IC UM3 (UMR 8104 / U1016) - Institut Cochin
30 Service de physiologie et explorations fonctionelles [CHU Cochin]
31 Service de radiologie [Avicenne]
32 CHIC - Centre Hospitalier Intercommunal de Créteil
33 U955 Inserm - UPEC - IMRB - CEPIA/"Clinical Epidemiology And Ageing : Geriatrics, Primary Care and Public Health" [Créteil]
Clairelyne Dupin
Stéfanie Habib
  • Fonction : Auteur
Nicolas Roche
  • Fonction : Auteur
Pierre-Yves Brillet

Résumé

Background Survivors of severe-to-critical COVID-19 may have functional impairment, radiological sequelae and persistent symptoms requiring prolonged follow-up. This pragmatic study aimed to describe their clinical follow-up and determine their respiratory recovery trajectories, and factors that could influence them and their health-related quality of life. Methods Adults hospitalised for severe-to-critical COVID-19 were evaluated at 3 months and up to 12 months post-hospital discharge in this prospective, multicentre, cohort study. Results Among 485 enrolled participants, 293 (60%) were reassessed at 6 months and 163 (35%) at 12 months; 89 (51%) and 47 (27%) of the 173 ones initially managed with standard oxygen were reassessed at 6 and 12 months, respectively. At 3 months, 34%, 70% and 56% of the participants had a restrictive lung defect, impaired DL CO and significant radiological sequelae, respectively. During extended follow-up, DL CO and FVC (% of predicted value) increased by means of +4 points at 6 months, and +6 points at 12 months. Sex, body mass index, chronic respiratory disease, immunosuppression, pneumonia extent or corticosteroid use during acute COVID-19 and prolonged invasive mechanical ventilation (IMV) were associated with DL CO at month 3, but not its trajectory thereafter. Among 475 (98%) patients with at least one chest computed-tomography scan during follow-up, 196 (41%) had significant sequelae on their last images. Conclusion Although pulmonary function and radiological abnormalities improved up to 1 year post-acute-COVID-19, high percentages of severe-to-critical disease survivors, including a notable proportion of those managed with standard oxygen, had significant lung sequelae and residual symptoms justifying prolonged follow-up.
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Dates et versions

hal-03958196 , version 1 (06-06-2023)

Identifiants

Citer

Frédéric Schlemmer, Simon Valentin, Laurent Boyer, Anne Guillaumot, François Chabot, et al.. Respiratory recovery trajectories after severe-to-critical COVID-19: a 1-year prospective multicentre study. European Respiratory Journal, 2023, 61 (4), pp.2201532. ⟨10.1183/13993003.01532-2022⟩. ⟨hal-03958196⟩
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