• Medicina · Jan 2023

    Clinical Trial

    [Clinical, functional and tomographic respiratory sequels of patients hospitalized for COVID-19 at one year of diagnosis: SECUELAR-19 TRIAL].

    • Alejandra González, Fernando Saldarini, Martín Sívori, Pamela Rossi, Alejandro Martínez Fraga, Mauro Andreu, Matías Bertozzi, Jaime Segovia-Roca, Florencia Trullas, and Grupo Secuelar-19.
    • Servicio de Neumonología, Hospital Nacional Alejandro Posadas, Buenos Aires, Argentina. E-mail: alestork@yahoo.com.ar.
    • Medicina (B Aires). 2023 Jan 1; 83 (5): 692704692-704.

    IntroductionThere is scarce information on longterm evolution of hospitalized patients with moderate (MP) and severe (SP) COVID-19 pneumonia.Objectiveto determine clinical, respiratory function, and tomographic (HRCT) impact after being discharged 12 months after diagnosis.MethodsAnalysis according to MP and SP, desaturator patients (DP) in 6-minute walking test (6MWT) and HRCT fibrotic-like pattern (FLP). Results compared at 3 and 12 months of follow-up.Results194 patients enrolled and one year later 103 (53%) were evaluated: gender male (62.4%), age 57.7 ± 10.9 years, comorbidities (arterial hypertension 38.8%, diabetes 29.6%, and respiratory diseases-RD-18.4%). Variables compared 3 months to 12 months (mean/SD): FVC: 84%( 19) to 88%( 19) (p= 0.01). A 27% of patients had FVC<80% at one year. In 6MWT:426 (108) to 447 (92) (p = <0.01). 12.8% are DP in one year. SP had a greater FLP than MP (40% vs. 27.9%, p = 0.021). The FLP group was related to FVC < 80% (p = 0.004) in all patients but only in SP (p < 0.001). After one year, in multivariate analysis, FVC < 80% was associated with RD (OR 4.32, 1.15-16.25), diabetes (OR 2.96, 1.02-8.57) and FLP (OR 3.51, 1.25-9.88). DP were associated with RD (OR 12.2, 2.41-61.85).DiscussionImprovement was observed in all variables when comparing 3 to 12 months. However, after one year, functional and tomographic alterations persist in less than 50% of patients. DP subgroup was related to RD. Protocolled follow-up of hospitalized patients is important, especially in SP, DP, and FLP groups.

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