One-Year Outcomes in Patients Who Survived COVID-19-Related Acute Respiratory Distress Syndrome (ARDS): Pulmonary Function Tests (PFTs), Oxygen Requirement, and Quality of Life (QoL)

Author(s): Rami Arfoosh, Rachel Nisbet, Kimtuyen Nguyen, Martin Herrera, Oluseyi Abidoye, Nathaniel Kim, Louise Jones

Background: The COVID-19 pandemic saw ARDS, caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), emerge as a predominant factor in patient mortality and morbidity. This study sought to gauge the first-year outcomes of survivors of COVID-19-induced ARDS in terms of pulmonary function, liberation from oxygen and QoL.

Methods: We retrospectively screened 492 patients and analyzed 29 patients from our pulmonary clinic who had post-COVID-19 ARDS. We assessed data points around the 3, 6, and 12-month marks, specifically focusing on pulmonary function, oxygen requirement and QoL using the 36-Item Short Form Survey (SF 36) questionnaire.

Results: Our cohort predominantly consisted of middle-aged males, with none having required invasive mechanical ventilation during their hospitalization. By the 3-month mark, a significant portion displayed reduced diffusion and restrictive patterns, with an ongoing oxygen requirement. Notably, all PFT parameters - diffusion, Forced Vital Capacity (FVC), and Forced Expiratory Volume in 1 second (FEV1) - registered improvement over the course of a year, with most of these enhancements becoming evident by the 6-month period. Both FEV1 and FVC approached normative values by the year's end. Diffusion capacity, despite marked enhancement, remained slightly abnormal at the 12-month evaluation. The proportion of patients on supplemental oxygen also dwindled considerably from 3 to 12 months, with significant reductions already observable at 6 months. Interestingly, while the SF 36 assessment for QoL did not evince consistent improvements across the board, social functioning was an exception, improving over the one-year span. The study began with participants holding an average SF 36 general health score of 63, compared to the population norm of 72.

Discussion: Survivors of COVID-19 ARDS, who didn't necessitate invasive mechanical ventilation, demonstrated significant lung function recovery and a decreasing dependence on oxygen supplementation over a year's duration. However, the SF 36 QoL scores remained relatively static, potentially indicating the impact of non-pulmonary factors on QoL.