Persistent Pulmonary Function Abnormalities And Quality Of Life One Year After Recovery From Moderate-To-Severe Covid-19: A Cross-Sectional Study At A Tertiary Care Hospital

Abstract

Background: Post-acute sequelae of SARS-CoV-2 (PASC) include persistent pulmonary functional abnormalities in a significant proportion of COVID-19 survivors, particularly those with moderate-to-severe acute disease. DLCO impairment, restrictive physiology, and radiological fibrotic ILAs at 12 months post-infection represent important unresolved issues with significant quality-of-life implications.

Methods: A cross-sectional study enrolled 180 adults attending a dedicated post-COVID OPD ≥12 months after confirmed COVID-19 recovery, previously hospitalised for moderate-to-severe disease. Spirometry with DLCO, 6MWT, HRCT chest (fibrotic ILA scoring), SGRQ, and mMRC dyspnoea were assessed.

Results: Persistent dyspnoea (mMRC ≥1) was present in 38.3%. DLCO <80% predicted was documented in 41.1%, consistent with the Christopher et al. CMC Vellore Indian cohort benchmark of 44.4% at ~63 days. Restrictive spirometry pattern persisted in 27.2%. Fibrotic ILAs on HRCT at 12 months were present in 22.2%. Mean 6MWD was 412±84 m; 28.3% had exercise-induced desaturation. Independent predictors of DLCO impairment included acute ICU admission, peak CT severity score ≥18/25, age ≥60, and diabetes.

Conclusion: Clinically significant pulmonary function abnormalities persist in 40% of moderate-to-severe COVID-19 survivors at 12 months. Systematic post-COVID pulmonary follow-up including DLCO, spirometry, HRCT, and 6MWT is warranted for all hospitalised COVID-19 survivors, with timely rehabilitation referral for those with impairment.