Functional and radiological changes in ICU survivors with COVID-19 at 1-year follow-up from the OUTSTRIP COVID-19 study

Abstract

Objective: We aimed to determine the radiological changes on computed tomography (CT) scans of the chest and pulmonary function abnormalities at a 1-year follow-up in intensive care unit (ICU) survivors with severe COVID-19.

Design: A 2-year prospective cohort study with an enrollment of 204 patients within 3 months after their discharge from the ICU at Hamad General Hospital, the tertiary care center in Qatar.

Main Results: The mean age of our cohort was 48.7 ± 8.6 years. CT chest was performed on a total of 135 patients at a 1-year follow-up, out of which 43 patients had a CT chest during hospital admission with COVID-19. Abnormal CT chest findings were seen in 118 (87.4%) patients at 1 year. The mean CT severity score significantly improved at 1 year (8.1 ± 6.8 vs. 19.4 ± 3.6, p < 0.001). Those with an abnormal CT chest in 1 year had a significantly lower but normal predicted forced vital capacity (91.9% ± 15.4 vs. 81.1% ± 13.7, p = 0.01), predicted total lung capacity (82.5% ± 13.9 vs. 94.3% ± 12.7, p = 0.02) and oxygen saturation after 6-minute walk test (6MWT) (97.5 ± 1.2 vs. 98.3 ± 0.651, p = 0.033). 6MWT distance was significantly shorter than the predicted distance in those with an abnormal CT (63 (62.4%) vs. 7 (77.8%), p = 0.020).

Conclusion: Patients recovering from severe COVID-19 have significant improvement but persistent radiological changes at a 1-year follow-up that correlate with several physiological parameters, but these findings are limited by the absence of pre-COVID-19 baseline imaging.