Functional respiratory complaints among COVID-19 survivors: a prospective cohort study
Antoine Beurnier, Laurent Savale, Xavier Jaïs, Romain Colle, Tài Pham, Luc Morin, Sophie Bulifon, Nicolas Noël, Athénaïs Boucly, Benoit Delbarre, Nathan Ebstein, Samy Figueiredo, Matthieu Gasnier, Anatole Harrois, Etienne‐Marie Jutant, Mitja Jevnikar, Sophia Keddache, Anne-Lise Lecoq, Olivier Meyrignac, Florence Parent, Jérémie Pichon, Mariana Preda, Anne Roche, Andrei Seferian, Marie‐France Bellin, Thomas Gille, Emmanuelle Corruble, Olivier Sitbon, Laurent Becquemont, Xavier Monnet, Marc Humbert, David Montani, and the Comebac Investigators, the Comebac Investigators, Luc Morin, Laurent Savale, Tài Pham, Romain Colle, Samy Figueiredo, Anatole Harrois, Matthieu Gasnier, Anne-Lise Lecoq, Olivier Meyrignac, Nicolas Noël, Élodie Baudry, Marie‐France Bellin, Antoine Beurnier, Walid Choucha, Emmanuelle Corruble, Laurent Dortet, Isabelle Hardy‐Léger, François Radiguer, Sabine Sportouch, Christiane Verny, Benjamin Wyplosz, Mohamad Zaidan, Laurent Becquemont, David Montani, Xavier Monnet
Abstract
Background: Dyspnoea is a common persistent symptom after COVID-19. Whether it is associated with functional respiratory disorders remains unclear. Methods: , symptomatic and/or intensive care unit (ICU) survivors at 4 months). In a distinct explanatory cohort of 21 consecutive individuals with unexplained post-COVID-19 dyspnoea after routine tests, we also analysed the physiological responses to incremental cardiopulmonary exercise testing (CPET). Findings: In the COMEBAC cohort, 37 patients had significant FRCs (20.9%, IC95: 14.9-26.9). The prevalence of FRCs ranged from 7.2% (ICU patients) to 37.5% (non-ICU patients). The presence of FRCs was significantly associated with more severe dyspnoea, lower 6-min walk distance, more frequent psychological and neurological symptoms (cognitive complaint, anxiety, depression, insomnia and post-traumatic stress disorders) and poorer quality of life (all p<0.01). In the explanatory cohort, seven out of 21 patients had significant FRCs. Based on CPET, dysfunctional breathing was identified in 12 out of 21 patients, five out of 21 had normal CPET, three out of 21 had deconditioning and one out of 21 had evidence of uncontrolled cardiovascular disease. Interpretation: FRCs are common during post-COVID-19 follow-up, especially among patients with unexplained dyspnoea. Diagnosis of dysfunctional breathing should be considered in those cases.