Long-Term Cardiopulmonary Function After COVID-19-Associated Acute Respiratory Distress Syndrome: A Multicenter Case-Control Study.

Publication date: Jul 01, 2025

This study aimed to evaluate long-term pulmonary function, cardiopulmonary exercise capacity, chest CT findings, and health-related quality of life (HRQoL) in survivors of COVID-19 complicated by acute respiratory distress syndrome (ARDS). This is a multicentric case-control study conducted from February 2023 to December of 2023. Pulmonary function tests, cardiopulmonary exercise testing (CPET), chest CT, and HRQoL (using EuroQol 5D three-level [EQ-5D-3L]) were performed at least 12 months after hospital discharge among cases (COVID-19 complicated by ARDS) and at the time of inclusion among controls (family members/friends matched for sex and age). None. A total of 114 COVID-19 ARDS survivors and 115 controls were included. The mean age was 54 years and 52. 4% of the participants were men. Time from hospital discharge to evaluation was 22 months (20. 99-41. 41 mo) among cases. Persistent symptoms, including memory loss (48. 2%), fatigue (42. 1%), and anxiety (31. 6%), were reported by 73. 6% of the COVID-19 ARDS survivors. Cases had significantly reduced pulmonary function, with lower diffusing capacity for carbon monoxide (DLCO) of 6. 85 mmol/min/Kpa (5. 44-8. 37 mmol/min/Kpa) vs. 7. 36 mmol/min/Kpa (6. 43-8. 96 mmol/min/Kpa; p = 0. 012) and % of predicted DLCO of 81. 0% (70. 2-90. 4%) vs. 89. 3% (78. 9-99. 9%; p < 0. 001), compared with controls, as well as a higher frequency of moderate to severe DLCO impairment (10. 5% vs. 0. 8%; p = 0. 002). In CPET, cases demonstrated lower peak oxygen consumption (21. 9 mL/kg/min [18. 2-29 mL/kg/min] vs. 25. 8 mL/kg/min [21. 6-31. 9 mL/kg/min]; p < 0. 001). Chest CT revealed a greater prevalence of ground-glass opacities in cases (53. 5% vs. 16. 5%; p < 0. 001) and emphysema (6. 1% vs. 0%; p = 0. 043). HRQoL, using EQ-5D-3L utility scores, were significantly lower in cases, with worse mobility (p < 0. 001), self-care (p < 0. 001), and anxiety/depression (p = 0. 04) dimension scores compared with controls. COVID-19 ARDS survivors exhibit significant long-term impairments in pulmonary function, exercise capacity, and quality of life and abnormal chest CT findings compared with family controls with same sex and age.

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