A Prospective Cohort Study (OUTSTRIP-COVID) on Functional and Spirometry Outcomes in COVID-19 ICU Survivors at 3 Months

Abstract

Merlin Thomas,1,2 Tasleem Raza,1– 3 Mansoor Hameed,1,2 Rohit Sharma,4 Rajalekshmi Maheswari Rajagopal,5 Aisha Hussain O Al Adab,1,2 Mushtaq Ahmad,1,2 Saibu George,2,3 Mousa Hussein,1 Jaweria Akram,3 Mohamed Izham Mohamed Ibrahim,6 Ali Ait Hssain,2,3 Muhammad Yousaf,2,7 Mohamad Yahya Khatib2,7 1Department of Chest, Hamad General Hospital, Doha, Qatar; 2Department of Clinical Medicine, Weill Cornell Medicine, Doha, Qatar; 3Department of Medical Intensive Care, Hamad General Hospital, Doha, Qatar; 4Department of Internal Medicine, Geisinger Health System, Danville, PA, USA; 5Department of Medical Research Centre, Hamad Medical Corporation, Doha, Qatar; 6Department of Clinical Pharmacy and Practice, Qatar University of Health, Doha, Qatar; 7Department of Chest, Hazm Mebaireekh General Hospital, Doha, QatarCorrespondence: Merlin Thomas, Department of Chest, Hamad General Hospital, Doha, Qatar, P.O.Box 3050, Tel [phone], Email [email protected]: COVID-19 pandemic resulted in a significant number of critical care admissions secondary to severe pneumonia and acute respiratory distress syndrome. We evaluated the short-, medium- and long-term outcomes of lung function and quality of life in this prospective cohort study and reported the outcomes at 7 weeks and 3 months from discharge from intensive care unit.Methods: A prospective cohort study of ICU survivors with COVID-19 was conducted from August 2020 to May 2021 to evaluate baseline demographic and clinical variables as well as determine lung function, exercise capacity, and health-related quality of life (HRQOL) using spirometry and 6-minute walk test (6MWT) conducted in accordance with American Thoracic Society standards, and SF-36 (Rand), respectively. SF-36 is a generic 36 question standardized health survey. Descriptive and inferential statistics (alpha = 0.05) were used to analyse the data.Results: At baseline, 100 participants were enrolled in the study of whom 76 followed up at 3 months. Majority of the patients were male (83%), Asians (84%) and less than 60 years of age (91%). HRQOL showed significant improvement in all domains of SF-36, except in emotional wellbeing. Spirometry variables also showed significant improvement in all variables over time with greatest improvement in percentage predicted Forced expiratory volume 1 (79% vs 88% p < 0.001). 6MWT showed significant improvement in variables of walk distance, dyspnea, and fatigue with greatest improvement in change in oxygen saturation (3% vs 1.44% p < 0.001). Intubation status did not impact the changes in SF-36, spirometry or 6MWT variables.Conclusion: Our findings suggest that ICU survivors of COVID-19 have significant improvement in their lung function, exercise capacity and HRQOL within 3 months of ICU discharge regardless of intubation status.Keywords: COVID-19, lung function, exercise capacity, health related quality of life

Keywords

• covid-19
• lung function
• exercise capacity
• health related quality of life