Hospital admission for COVID-19 pneumonitis - long-term impairment in quality of life and lung function

Background and Aim

Knowledge of long-term consequences of severe COVID-19 pneumonitis is of outmost importance. Our aim was, therefore, to assess the long-term impact on quality of life and lung function in adults hospitalized with severe COVID-19.

Methods

All patients hospitalized with COVID-19 pneumonitis at Copenhagen University Hospital-Hvidovre, Denmark, were invited to participate in the study 4–5 months after discharge. Of the 160 invited 128 responded positively (80%). Medical history and symptoms were assessed, and patients rated impact on quality of life and functional status with EuroQol-5D-5L and Post Covid Functional Scale. Lung function was assessed by dynamic spirometry and measurement of diffusing capacity.

Results

Fatigue, dyspnea, cough and cognitive dysfunction were the most common symptoms. Of 128 patients, 85% had at least one symptom, and 51% reported two or more symptoms. Self-rated Quality of life was impaired assessed by EuroQol 5D-5L, with dimensions ‘Pain or discomfort’ (61%) and ‘Usual activities’ (54%) mostly affected. Functional status was significantly worse than before COVID-19 assessed by Post-COVID Functional Scale. Among lung function parameters, diffusing capacity was most affected, with 45% having diffusing capacity < 80% of predicted.

Conclusion

Fatigue, respiratory symptoms and cognitive symptoms are highly common months after hospitalization for severe COVID-19. Compared to pre-COVID-19, functional status and usual activities continued to be impaired. In line with this, almost half of the patients were found to have impaired diffusing capacity.

[Extracorporeal membrane oxygenation treatment for a patient with life-threatening asthma]

This is a case report of a young male with life-threatening asthma presenting hypercapnia and respiratory acidosis despite mechanical ventilation and intense broncholytic medication. He was treated with venovenous extracorporeal membrane oxygenation (VV-ECMO) through a double-lumen catheter placed in the right jugular vein. This patient, as well as two other comparable patients, improved respiratory and circulatory within 3 h of VV-ECMO treatment. Smaller low-flow ECMO devices for CO₂ removal are emerging but attention should be kept on the fact, that they are not capable of oxygenation.