Pulmonary Function and Quality of Life in a Prospective Cohort of (non-) Hospitalized COVID-19 Pneumonia Survivors Up to Six Months

Objectives: A decrease of both diffusion capacity (DLCO) and Quality of Life (QoL) was reported after discharge in hospitalized COVID-19 pneumonia survivors. We studied three and 6 month outcomes in hospitalized and non-hospitalized patients.

Methods: COVID-19 pneumonia survivors ( = 317) were categorized into non-hospitalized "moderate" cases ( = 59), hospitalized "severe" cases ( = 180) and ICU-admitted "critical" cases ( = 39). We studied DLCO and QoL (Short Form SF-36 health survey) 3 and 6 months after discharge. Data were analyzed using (repeated measures) ANOVA, Kruskal-Wallis or Chi-square test ( < .05).

Results: At 3 months DLCO was decreased in 44% of moderate-, 56% of severe- and 82% of critical cases ( < .003). Mean DLCO in critical cases (64±14%) was lower compared to severe (76 ± 17%) and moderate (81±15%) cases ( < .001). A total of 159/278 patients had a decreased DLCO (<80%), of whom the DLCO improved after 6 months in 45% (71/159). However the DLCO did not normalize in the majority (89%) of the cases (63 ± 10% vs 68±10%; < .001). At 3 months, compared to critical cases, moderate cases scored lower on SF-36 domain "general health" ( < .05); both moderate and severe cases scored lower on the domain of "health change" ( < .05). At 6 months, there were no differences in SF-36 between the subgroups. Compared to 3 months, in all groups "physical functioning" improved; in contrast all groups scored significantly lower on "non-physical" SF-36 domains.

Conclusion: Three months after COVID-19 pneumonia, DLCO was still decreased in the more severely affected patients, with an incomplete recovery after 6 months. At 3 months QoL was impaired. At 6 months, while "physical functioning" improved, a decrease in "non-physical" QoL was observed but did not differ between the moderate and severely affected patients.