Six and twelve-month respiratory outcomes in a cohort of severe and critical COVID-19 survivors: A prospective monocentric study in Latin America

Liliana Fernández-Trujillo; Juan Sebastián Galindo-Sánchez; Angie Cediel; Carlos A García; Eliana I Morales; Jessica Largo; María A Amezquita-Dussan

doi:10.1177/20503121241275369

Six and twelve-month respiratory outcomes in a cohort of severe and critical COVID-19 survivors: A prospective monocentric study in Latin America

SAGE Open Med. 2024 Sep 9:12:20503121241275369. doi: 10.1177/20503121241275369. eCollection 2024.

Authors

Liliana Fernández-Trujillo^{1

2}, Juan Sebastián Galindo-Sánchez³, Angie Cediel^{4

2}, Carlos A García^{4

2}, Eliana I Morales^{1

2}, Jessica Largo³, María A Amezquita-Dussan³

Affiliations

¹ Department of Internal Medicine, Pulmonology Service, Fundación Valle del Lili, Cali, Colombia.
² Faculty of Health Sciences, Universidad Icesi, Cali, Colombia.
³ Clinical Research Center, Fundación Valle del Lili, Cali, Colombia.
⁴ Department of Diagnostic Imaging Fundación Valle del Lili, Cali, Colombia.

Abstract

Introduction: Severe COVID-19 can result in long-term sequelae known as "chronic COVID," characterized by a wide range of persistent physical and mental symptoms. Chest imaging and pulmonary function test alterations have been observed in recovered patients. Most studies focus on up to a 3-month follow-up after symptom onset or hospital discharge, with few reports on long-term follow-up and limited evidence regarding disease progression in Latin America.

Methods: This study aims to describe the clinical characteristics and changes in pulmonary function, imaging, and quality of life in severe and critical COVID-19 patients requiring ICU admission in a high-complexity hospital in Latin America. A prospective cohort of survivors underwent clinical, radiological, pulmonary function, and quality of life assessments 6 and 12 months post-discharge.

Results: One hundred twelve patients were included, all of whom attended the 6-month follow-up, and 99 returned for the 12-month follow-up. Most subjects had no previous respiratory symptoms or significant medical history. At the end of the follow-up period, 74% of the patients showed interstitial infiltrates in chest tomography and a higher frequency of fibroatelectatic tracts and parenchymal bands. Pulmonary function tests returned to normal ranges, except for carbon monoxide diffusion, but no altered scores were reported in the questionnaires.

Conclusion: Despite residual radiological findings, most parameters studied in severe and critical COVID-19 survivors improved over the 12-month follow-up period. Regardless of the imaging abnormalities, the improvement in variables such as symptomatic relief and normal pulmonary function suggests that these alterations are transient. Carbon monoxide diffusion did not normalize by the end of the follow-up, which is consistent with the abnormalities reported in multiple studies, indicating a potential disease-related pattern.

Keywords: COVID-19; SARS-CoV-2; X-ray; follow-up study; pulmonary function tests; tomography.