RESEARCH ARTICLE


Investigation of in Hospital COVID-19 Mortality and One-year Follow-up of Lung Function and Health Status



Jonas Agholme1, Karin Cederquist1, Konstantinos Vougas2, Mirjam Schimanke1, 3, Tove Eldh1, 3, Petros Effraimidis1, Christina Triantafyllidou1, *
1 Department of Internal Medicine, Section of Pulmonary Medicine, Vrinnevi Hospital, Norrköping, Sweden
2 Biomedical Research Foundation of the Academy of Athens, 4 Soranou Ephessiou Str., Athens 11527, Greece; Molecular Carcinogenesis Group, Department of Histology and Embryology, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias Str., Athens 11527, Greece
3 Department of Internal Medicine, COVID-19 outpatient department, Vrinnevi Hospital, Norrköping, Sweden


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Creative Commons License
© 2022 Agholme et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Internal Medicine, Section of Pulmonary Medicine, Vrinnevi Hospital, Norrköping, Sweden; E-mail: xristina.triantafyllidou@gmail.com


Abstract

Background:

Globally, thousands of patients suffer from postacute COVID-19 syndrome, a condition that already affects our health system. Although there is a growing literature upon the long-term effects of SARS-CoV-2 infection, there are up to date only a few reports on long-term follow-up of pulmonary function after severe COVID-19.

Objective:

To investigate risk factors for in-hospital COVID-19 fatalities and to assess the lung function and health status at one year after hospital discharge.

Methods:

Patients who were admitted to the hospital with confirmed COVID-19 and required supplementary oxygen delivery were included in this observational cohort study. Baseline and demographic data and information about hospital stay were obtained by medical charts. Patients were divided in 3 groups: group 1 (intensive care unit (ICU)-invasive mechanical ventilation (IMV), group 2 (high-flow nasal cannula (HFNC) and/or none-invasive ventilation (NIV) and group 3 (regular oxygen delivery treatment). All patients were required to answer health questionnaires at one year after acute infection, while patients in groups 1 and 2 performed dynamic spirometry.

Results:

The study population consisted of 130 patients. Forty five (35%) patients died at the hospital. Risk factors for in-hospital mortality were age, hypertension, ischemic heart disease, and renal disease. We did not find any significant difference in health scales between the 3 groups. Mean values of both FEV1% and FVC% in groups 1 and 2 were detected within the lower normal limits with no difference between the two groups.

Conclusion:

The main result of the study is lung function in the lower limit of normal evaluated at one-year follow-up. There were no significant differences related to initial disease severity in lung function and long-term health status, which suggests that more generous lung function testing even in less severely affected patients, could be indicated.

Keywords: Post-acute COVID-19, In-hospital mortality, Pulmonary function tests, Invasive mechanical ventilation, High-flow nasal cannula, Post-COVID-19 functional status scale, Outcome.