BMC Pulmonary Medicine (Nov 2023)

Comparison of the 12-month impact of COVID-19 and SARS on physiological capacity and health-related quality of life

  • Ken Ka Pang Chan,
  • Susanna So Shan Ng,
  • Grace Chung Yan Lui,
  • Ho Sang Leung,
  • Ka Tak Wong,
  • Winnie Chiu Wing Chu,
  • Tat On Chan,
  • Karen Yee Shan Yiu,
  • Eugene Yuk Keung Tso,
  • Kin Wang To,
  • Jenny Chun Li Ngai,
  • Tommy Wing Ho Yip,
  • Rachel Lai Ping Lo,
  • Joyce Ka Ching Ng,
  • Fanny Wai San Ko,
  • David Shu Cheong Hui

DOI
https://doi.org/10.1186/s12890-023-02750-8
Journal volume & issue
Vol. 23, no. 1
pp. 1 – 12

Abstract

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Abstract Background Little is known about the differences in medium to long-term recovery on spirometry, 6-minute walking distance (6MWD) and health-related quality of life (HRQoL) between COVID-19 and SARS. Methods We performed a 12-month prospective study on COVID-19 survivors. The changes in dynamic lung volumes at spirometry (%predicted FEV1, %predicted FVC), 6MWD and HRQoL at 1–3, 6 to 12 months were compared against a historical cohort of SARS survivors using the same study protocol. The residual radiological changes in HRCT in COVID-19 survivors were correlated with their functional capacity. Results 108 COVID-19 survivors of various disease severity (asymptomatic 2.9%, mild 33.3%, moderate 47.2%, severe 8.3%, critical 8.3%) were recruited. When compared with 97 SARS survivors, 108 COVID-19 survivors were older (48.1 ± 16.4 vs. 36.1 ± 9.5 years, p < 0.001) and required less additional support during hospitalization; with lower dynamic lung volumes, shorter 6MWD and better physical component score. Both groups of survivors had comparable changes in these parameters at subsequent follow-ups. Both COVID-19 and SARS survivors had similar mental component score (MCS) at 6 and 12 months. COVID-19 survivors initially experienced less (between-group difference, -3.1, 95% confidence interval [CI] -5.5 to -0.7, p = 0.012) and then more improvement (between-group difference 2.9, 95%, CI 0.8 to 5.1, p = 0.007) than SARS survivors in the MCS at 1–3 to 6 months and 6 to 12 months respectively. Forty (44.0%) out of 91 COVID-19 survivors had residual abnormalities on HRCT at 12 months, with a negative correlation between the severity scores of parenchymal changes and 6MWD (r=-0.239, p < 0.05). Conclusions COVID-19 survivors demonstrated a similar recovery speed in dynamic lung volumes and exercise capacity, but different paces of psychological recovery as SARS survivors in the convalescent phase. The severity of parenchymal changes in HRCT is negatively correlated with the 6MWD of COVID-19 survivors. Trial registration This prospective study was registered at ClinicalTrials.gov on 2 November 2020 (Identifier: NCT04611243).

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