Respiratory symptoms and radiological findings in post-acute COVID-19 syndrome
Etienne-Marie Jutant
(1, 2)
,
Olivier Meyrignac
(3)
,
Antoine Beurnier
(2)
,
Xavier Jaïs
(4, 5, 2)
,
Tai Pham
,
Luc Morin
(4, 6)
,
Athénaïs Boucly
(7, 8, 4, 2)
,
Sophie Bulifon
(9, 10, 4, 2)
,
Samy Figueiredo
(4)
,
Anatole Harrois
(4, 10, 2)
,
Mitja Jevnikar
(4, 5, 2)
,
Nicolas Noël
(11, 12, 13)
,
Jérémie Pichon
(9, 10, 4)
,
Anne Roche
(2)
,
Andrei Seferian
(9, 10, 4, 2)
,
Samer Soliman
(14)
,
Jacques Duranteau
(4, 15)
,
Laurent Becquemont
(16, 4)
,
Xavier Monnet
(4, 5, 2)
,
Olivier Sitbon
(4, 5, 2)
,
Marie-France Bellin
,
Marc Humbert
(2)
,
Laurent Savale
(2)
,
David Montani
(2)
1
CIC 1402 -
CIC Poitiers – Centre d'investigation clinique de Poitiers
2 HPPIT - Hypertension pulmonaire : physiopathologie et innovation thérapeutique
3 Service de Radiologie [Rangueil / Larrey]
4 Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
5 Pôle des Cardiopathies Congénitales du Nouveau-Né à L'adulte - Centre Constitutif Cardiopathies Congénitales Complexes M3C, Groupe Hospitalier Paris Saint-Joseph, Hôpital Marie-Lannelongue, Inserm U999, Université Paris-Saclay
6 I2BC - Institut de Biologie Intégrative de la Cellule
7 Faculté de Médecine Paris-Saclay
8 Hôpital Marie-Lannelongue
9 HPPIT - Hypertension arterielle pulmonaire physiopathologie et innovation thérapeutique
10 Université Paris-Saclay
11 Service de Médecine Interne - Immunologie Clinique [AP-HP Bicêtre]
12 IMVA - U1184 - Immunologie des Maladies Virales et Autoimmunes
13 IDMIT - Infectious Diseases Models for Innovative Therapies
14 Département de Radiologie [AP-HP Hôpital Bicêtre]
15 HUPS - Hôpitaux Universitaires Paris Sud [AP-HP]
16 CESP - Centre de recherche en épidémiologie et santé des populations
2 HPPIT - Hypertension pulmonaire : physiopathologie et innovation thérapeutique
3 Service de Radiologie [Rangueil / Larrey]
4 Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
5 Pôle des Cardiopathies Congénitales du Nouveau-Né à L'adulte - Centre Constitutif Cardiopathies Congénitales Complexes M3C, Groupe Hospitalier Paris Saint-Joseph, Hôpital Marie-Lannelongue, Inserm U999, Université Paris-Saclay
6 I2BC - Institut de Biologie Intégrative de la Cellule
7 Faculté de Médecine Paris-Saclay
8 Hôpital Marie-Lannelongue
9 HPPIT - Hypertension arterielle pulmonaire physiopathologie et innovation thérapeutique
10 Université Paris-Saclay
11 Service de Médecine Interne - Immunologie Clinique [AP-HP Bicêtre]
12 IMVA - U1184 - Immunologie des Maladies Virales et Autoimmunes
13 IDMIT - Infectious Diseases Models for Innovative Therapies
14 Département de Radiologie [AP-HP Hôpital Bicêtre]
15 HUPS - Hôpitaux Universitaires Paris Sud [AP-HP]
16 CESP - Centre de recherche en épidémiologie et santé des populations
Etienne-Marie Jutant
- Fonction : Auteur
- PersonId : 772690
- ORCID : 0000-0002-1374-1890
- IdRef : 22021106X
Antoine Beurnier
- Fonction : Auteur
- PersonId : 1209405
- ORCID : 0000-0002-0481-3266
Xavier Jaïs
- Fonction : Auteur
Tai Pham
- Fonction : Auteur
Mitja Jevnikar
- Fonction : Auteur
Xavier Monnet
- Fonction : Auteur
Olivier Sitbon
- Fonction : Auteur
- PersonId : 763553
- ORCID : 0000-0002-1942-1951
- IdRef : 081152221
Marie-France Bellin
- Fonction : Auteur
Marc Humbert
- Fonction : Auteur
- PersonId : 756837
- ORCID : 0000-0003-0703-2892
- IdRef : 071559426
Laurent Savale
- Fonction : Auteur
- PersonId : 761036
- ORCID : 0000-0002-6862-8975
- IdRef : 098817345
David Montani
- Fonction : Auteur
- PersonId : 765451
- ORCID : 0000-0002-9358-6922
- IdRef : 092632580
Résumé
Rationale The characteristics of patients with respiratory complaints and/or lung radiologic abnormalities after hospitalisation for coronavirus disease 2019 (COVID-19) are unknown. The objectives were to determine their characteristics and the relationships between dyspnoea, radiologic abnormalities and functional impairment. Methods In the COMEBAC (Consultation Multi-Expertise de Bicêtre Après COVID-19) cohort study, 478 hospital survivors were evaluated by telephone 4 months after hospital discharge, and 177 who had been hospitalised in an intensive care unit (ICU) or presented relevant symptoms underwent an ambulatory evaluation. New-onset dyspnoea and cough were evaluated, and the results of pulmonary function tests and high-resolution computed tomography of the chest were collected. Results Among the 478 patients, 78 (16.3%) reported new-onset dyspnoea, and 23 (4.8%) new-onset cough. The patients with new-onset dyspnoea were younger (56.1±12.3 versus 61.9±16.6 years), had more severe COVID-19 (ICU admission 56.4% versus 24.5%) and more frequent pulmonary embolism (18.0% versus 6.8%) (all p≤0.001) than patients without dyspnoea. Among the patients reassessed at the ambulatory care visit, the prevalence of fibrotic lung lesions was 19.3%, with extent <25% in 97% of the patients. The patients with fibrotic lesions were older (61±11 versus 56±14 years, p=0.03), more frequently managed in an ICU (87.9 versus 47.4%, p<0.001), had lower total lung capacity (74.1±13.7 versus 84.9±14.8% pred, p<0.001) and diffusing capacity of the lung for carbon monoxide ( D LCO ) (73.3±17.9 versus 89.7±22.8% pred, p<0.001). The combination of new-onset dyspnoea, fibrotic lesions and D LCO <70% pred was observed in eight out of 478 patients. Conclusions New-onset dyspnoea and mild fibrotic lesions were frequent at 4 months, but the association of new-onset dyspnoea, fibrotic lesions and low D LCO was rare.