Individuals who survived COVID-19 (SARS-CoV-2) required less respiratory support during hospitalization than individuals who survived severe acute respiratory syndrome coronavirus 1(SARS-CoV-1), according to study findings published in BMC Pulmonary Medicine.

SARS-CoV-1 resulted in 8098 patients infected worldwide and 774 deaths. Globally, COVID-19 deaths have totaled 6.9 million. To date, no study has compared long-term recovery between those surviving SARS-CoV-1 vs COVID-19. Investigators therefore assessed how changes in exercise tolerance, dynamic lung volumes, and health-related quality of life (HRQoL) differed over time (medium to long-term) in COVID-19 vs SARS-CoV-1.

The investigators reported results from an ongoing longitudinal prospective follow-up study (ClinicalTrials.gov Identifier: NCT04611243) that included 108 consecutive patients with COVID-19 regardless of disease severity. Participants had survived the major outbreak in Hong Kong between February 2020 and August 2020 and were discharged from 3 tertiary care hospitals. Reverse transcription-polymerase chain reaction test confirmed SARS-CoV-2 in all patients. These individuals (2.9% asymptomatic; 33.3% mild; 47.2% moderate; 8.3% severe; 8.3% critical) were compared with a historical cohort of 97 consecutive patients with SARS-CoV-1 who survived the major outbreak in July 2003.

Those who survived COVID-19 (52% women; 0% COVID-19 reinfection; 0% vaccinated with any COVID-19 vaccination) vs SARS-CoV-1 were older (mean [SD] age, 48.1 [16.4] years vs 36.1 [9.5] years; P <.001), had lower dynamic lung volumes, a better physical component score, and required less additional support during hospitalization. At 1 to 3 months, COVID-19 survivors vs SARS-CoV-1 survivors had lower percent predicted forced expiratory volume in 1 second (FEV1; 98.7 vs 107.5); lower percent predicted forced vital capacity (FVC; 94.6 vs 102.8); and lower percent predicted diffusion capacity for carbon monoxide (DLCO; 83.5 vs 105.2), respectively. At 6 months, those who survived COVID-19 vs SARS-CoV-1 had shorter 6-minute walk distance (6MWD; 397.4 vs 501.3). At subsequent follow-ups, both groups experienced comparable changes in these parameters.

COVID-19 survivors demonstrated a similar recovery speed in dynamic lung volumes and exercise capacity, but different paces of psychological recovery as SARS survivors in the convalescent phase.

The investigators noted both groups had similar mental component scores (MCSs, a health-related quality of life [HRQoL] measurement) at 6 and 12 months; however, individuals in the COVID-19 group experienced less improvement in the mental component scores during the first 6 months than individuals in the SARS-CoV-1 group (between-group difference, -3.1; 95% CI, -5.5 to -0.7; P =.012) From months 6 to 12, the COVID-19 group experienced more improvement in MCS than the SARS-CoV-1 group (between-group difference, 2.9; 95% CI, 0.8 to 5.1; P =.007).

Radiological abnormalities were noted on high resolution computed tomography (HRCT) in 40/91 of those in the COVID-19 group at 12 months (23 had parenchymal bands, 13 had pleural thickening, 12 had interlobular lines, 12 had GGO, 7 had bronchiectasis, 4 had mosaic attenuation, and 2 had emphysema). These abnormalities were related to the need for intensive care unit admission, oxygen, mechanical ventilation, and corticosteroids.

Study limitations include limited lung function testing results from those with COVID-19 in the early study period; lack of HRCT in those with COVID-19 during acute care and interim follow-ups; the inability to directly compare radiological findings between the 2 cohorts due to lack of routine HRCT in the SARS-CoV-1 cohort; and potential selection bias in the COVID-19 cohort.

“COVID-19 survivors demonstrated a similar recovery speed in dynamic lung volumes and exercise capacity, but different paces of psychological recovery as SARS survivors in the convalescent phase,” the study authors concluded. “The severity of parenchymal changes in HRCT is negatively correlated with the 6MWD of COVID-19 survivors,” the researchers added.

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