Daines, Luke;
Zheng, Bang;
Elneima, Omer;
Harrison, Ewen;
Lone, Nazir I;
Hurst, John R;
Brown, Jeremy S;
... Sheikh, Aziz; + view all
(2022)
Characteristics and risk factors for post-COVID breathlessness after hospitalisation for COVID-19.
ERJ Open Research
10.1183/23120541.00274-2022.
(In press).
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Abstract
BACKGROUND: Persistence of respiratory symptoms—particularly breathlessness—after acute COVID-19 infection has emerged as a significant clinical problem. We aimed to characterise and identify risk factors for patients with persistent breathlessness following COVID-19 hospitalisation. METHODS: PHOSP-COVID is a multi-centre prospective cohort study of UK adults hospitalised for COVID-19. Clinical data were collected during hospitalisation and at a follow-up visit. Breathlessness was measured by a numeric rating scale of 0–10. We defined post-COVID breathlessness as an increase in score of 1 or more compared to the pre-COVID-19 level. Multivariable logistic regression was used to identify risk factors, and to develop a prediction model for post-COVID breathlessness. RESULTS: We included 1226 participants (37% female, median age 59 years, 22% mechanically ventilated). At a median five months after discharge, 50% reported post-COVID breathlessness. Risk factors for post-COVID breathlessness were socio-economic deprivation (adjusted odds ratio, 1.67; 95% confidence interval, 1.14–2.44), pre-existing depression/anxiety (1.58; 1.06–2.35), female sex (1.56; 1.21–2.00) and admission duration (1.01; 1.00–1.02). Black ethnicity (0.56; 0.35–0.89) and older age groups (0.31; 0.14–0.66) were less likely to report post-COVID breathlessness. Post-COVID breathlessness was associated with worse performance on the shuttle walk test and forced vital capacity, but not with obstructive airflow limitation. The prediction model had fair discrimination (concordance-statistic 0.66; 0.63–0.69), and good calibration (calibration slope 1.00; 0.80–1.21). CONCLUSIONS: Post-COVID breathlessness was commonly reported in this national cohort of patients hospitalised for COVID-19 and is likely to be a multifactorial problem with physical and emotional components.
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