S55\u2005Clinical, radiological, functional and psychological characteristics of severe COVID-19 pneumonia survivors: a prospective observational cohort study

Abstract

S55 Table 1Baseline characteristicsAge (years) 58 7 ± 14 4 Sex Female 45 (37 8;29 4–46 2) Male 74 (62 2;53 8–70 6) Ethnicity BAME (Yes/No) 83 (69 7;61 3–78 2) White 36 (30 3;22 6–37 8) Black 52 (43 7;36 1–51 3) Asian 18 (15 1;10 1–20 2) Mixed race 5 (4 2;1 7–6 7) Other 8 (6 7;3 4–10 9) Index of multiple deprivation score (n=115) 26 6 ± 9 7 Body Mass Index (kg/m2) (n=118) 30 0 (25 9–35 2) Charlson comorbidity index 2 (1–4) Admission PaO2:FiO2 168 8 (105 9–272 3) Critical care admission 41 (34 5;26 9–42 9) COVID-19 complications None during admission 49 (41 2;33 6–48 7) Venous thromboembolism 27 (22 7;16 8–29 4) Pulmonary embolism 23 (19 3;12 6–26 1) Deep vein thrombosis 6 (5 0;2 5–7 6) Acute kidney injury 41 (34 5;25 2–43 7) Deranged liver function 17 (14 3;9 2–20 2) Delirium 18 (15 1;10 1–20 2) Data presented as mean ± SD, median (IQR) or frequency (%;95% confidence interval) Abbreviations: BAME = Black, Asian or Minority Ethnic, PaO2:FiO2 = ratio of arterial partial pressure of oxygen to fraction of inspired oxygen Results119 consecutive patients attended clinic between 3rd June and 2nd July 2020, at median (IQR) 61 (51–67) days post discharge Baseline characteristics are presented in table 1 Despite apparent radiographic resolution of lung infiltrates in the majority (RALE score <5 in 87% of patients), patients commonly reported persistent fatigue (78/115 (67 8%;95%CI 60 0–76 5)), sleep disturbance (65/115 (56 5;47 3–66 1)) and breathlessness (37/115 (32 2;25 2–40 0)) mMRC breathlessness score was above pre-COVID baseline in 55/115 (46 2;37 8–54 6) Burdensome cough was less common (8/115 (7 0;3 5–10 4)) 56 thoracic computed tomography scans were performed, of which 75% demonstrated COVID-related interstitial lung disease and/or airways disease Significant depression (PHQ-9 ≥9) or anxiety (GAD-7 ≥9) were present in 20/111 (18 0;11 7–23 4) and 25/113 (22 1;15 0–29 8), respectively The Trauma Screening Questionnaire was positive (≥6) in 28/113 (24 8;18 1–31 9) Post-COVID functional scale was ≥2 in 47/115 (40 9;33 0–47 8) 4MGS was <0 8 m/s in 44/115 (38 3;29 6–46 1), 39/109 (34 5;26 5–41 6) desaturated by ≥4% during STS, 25/32 (78 1;62 5–93 1) who desaturated also had abnormal CT findings ConclusionsPersistent symptoms, functional limitation and adverse mental health outcomes are common 8 weeks after severe COVID-19 pneumonia Follow-up chest radiograph is a poor marker of recovery Physiological testing to identify oxygen desaturation is useful for triaging patients for further investigation Face-to-face or virtual clinical assessments are recommended to facilitate early recognition and management of post-COVID sequelae in this vulnerable cohort