Determinants of recovery from post-COVID-19 dyspnoea: analysis of UK prospective cohorts of hospitalised COVID-19 patients and community-based controls

PHOSP-COVID Study Collaborative Group; Bang Zheng; Giulia Vivaldi; Luke Daines; Olivia C Leavy; Matthew  Richardson; Omer Elneima; Hamish J C McAuley; Aarti Shikotra; Amisha Singapuri; Marco Sereno; Ruth M Saunders; Victoria C Harris; Linzy Houchen-Wolloff; Neil J Greening; Paul E Peffer; John R. Hurst; Jeremy S Brown; Manu Shankar-Hari; Carlos Echevarria; Anthony De Soyza; Ewen M Harrison; Annemarie B Docherty; Nazir I Lone; Jennifer K Quint; James D Chalmers; Ling-Pei Ho; Alex Horsley; Michael P Marks; Krishna Poinasamy; Betty Raman; Liam G Heaney; Louise V Wain; Rachael A Evans; Christopher E Brightling; Adrian R. Martineau; Aziz Sheikh

doi:10.1016/j.lanepe.2023.100635

Determinants of recovery from post-COVID-19 dyspnoea: analysis of UK prospective cohorts of hospitalised COVID-19 patients and community-based controls

PHOSP-COVID Study Collaborative Group, Bang Zheng, Giulia Vivaldi, Luke Daines, Olivia C Leavy, Matthew Richardson, Omer Elneima, Hamish J C McAuley, Aarti Shikotra, Amisha Singapuri, Marco Sereno, Ruth M Saunders, Victoria C Harris, Linzy Houchen-Wolloff, Neil J Greening, Paul E Peffer, John R. Hurst, Jeremy S Brown, Manu Shankar-Hari, Carlos EchevarriaAnthony De Soyza, Ewen M Harrison, Annemarie B Docherty, Nazir I Lone, Jennifer K Quint, James D Chalmers, Ling-Pei Ho, Alex Horsley, Michael P Marks, Krishna Poinasamy, Betty Raman, Liam G Heaney, Louise V Wain, Rachael A Evans, Christopher E Brightling, Adrian R. Martineau, Aziz Sheikh^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract / Description of output

Background The risk factors for recovery from COVID-19 dyspnoea are poorly understood. We investigated determinants of recovery from dyspnoea in adults with COVID-19 and compared these to determinants of recovery from non-COVID-19 dyspnoea.

Methods We used data from two prospective cohort studies: PHOSP-COVID (patients hospitalised between March 2020 and April 2021 with COVID-19) and COVIDENCE UK (community cohort studied over the same time period). PHOSP-COVID data were collected during hospitalisation and at 5-month and 1-year follow-up visits. COVIDENCE UK data were obtained through baseline and monthly online questionnaires. Dyspnoea was measured in both cohorts with the Medical Research Council Dyspnoea Scale. We used multivariable logistic regression to identify determinants associated with a reduction in dyspnoea between 5-month and 1-year follow-up.

Findings We included 990 PHOSP-COVID and 3309 COVIDENCE UK participants. We observed higher odds of improvement between 5-month and 1-year among PHOSP-COVID participants who were younger (odds ratio 1.02 per year, 95% CI 1.01–1.03), male (1.54, 1.16–2.04), neither obese nor severely obese (1.82, 1.06–3.13 and 4.19, 2.14–8.19, respectively), had no pre-existing anxiety/depression (1.56, 1.09–2.22) or cardiovascular disease (1.33, 1.00–1.79), and shorter hospital admission (1.01 per day, 1.00–1.02). Similar associations were found in those recovering from non-COVID-19 dyspnoea, excluding age (and length of hospital admission).

Interpretation Factors associated with dyspnoea recovery at 1-year post-discharge among patients hospitalised with COVID-19 were similar to those among community controls without COVID-19.

Original language	English
Article number	100635
Journal	The Lancet Regional Health - Europe
Volume	29
Early online date	28 Apr 2023
DOIs	https://doi.org/10.1016/j.lanepe.2023.100635
Publication status	Published - Jun 2023

Keywords / Materials (for Non-textual outputs)

COVID-19
Cohort
Dyspnoea
Long COVID
Recovery

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PHOSP-COVID Study Collaborative Group, Zheng, B., Vivaldi, G., Daines, L., Leavy, O. C., Richardson, M., Elneima, O., McAuley, H. J. C., Shikotra, A., Singapuri, A., Sereno, M., Saunders, R. M., Harris, V. C., Houchen-Wolloff, L., Greening, N. J., Peffer, P. E., Hurst, J. R., Brown, J. S., Shankar-Hari, M., ... Sheikh, A. (2023). Determinants of recovery from post-COVID-19 dyspnoea: analysis of UK prospective cohorts of hospitalised COVID-19 patients and community-based controls. The Lancet Regional Health - Europe, 29, Article 100635. Advance online publication. https://doi.org/10.1016/j.lanepe.2023.100635

@article{25b99aa61379483a946101d05f23adc0,

title = "Determinants of recovery from post-COVID-19 dyspnoea: analysis of UK prospective cohorts of hospitalised COVID-19 patients and community-based controls",

abstract = "Background The risk factors for recovery from COVID-19 dyspnoea are poorly understood. We investigated determinants of recovery from dyspnoea in adults with COVID-19 and compared these to determinants of recovery from non-COVID-19 dyspnoea. Methods We used data from two prospective cohort studies: PHOSP-COVID (patients hospitalised between March 2020 and April 2021 with COVID-19) and COVIDENCE UK (community cohort studied over the same time period). PHOSP-COVID data were collected during hospitalisation and at 5-month and 1-year follow-up visits. COVIDENCE UK data were obtained through baseline and monthly online questionnaires. Dyspnoea was measured in both cohorts with the Medical Research Council Dyspnoea Scale. We used multivariable logistic regression to identify determinants associated with a reduction in dyspnoea between 5-month and 1-year follow-up.Findings We included 990 PHOSP-COVID and 3309 COVIDENCE UK participants. We observed higher odds of improvement between 5-month and 1-year among PHOSP-COVID participants who were younger (odds ratio 1.02 per year, 95% CI 1.01–1.03), male (1.54, 1.16–2.04), neither obese nor severely obese (1.82, 1.06–3.13 and 4.19, 2.14–8.19, respectively), had no pre-existing anxiety/depression (1.56, 1.09–2.22) or cardiovascular disease (1.33, 1.00–1.79), and shorter hospital admission (1.01 per day, 1.00–1.02). Similar associations were found in those recovering from non-COVID-19 dyspnoea, excluding age (and length of hospital admission).Interpretation Factors associated with dyspnoea recovery at 1-year post-discharge among patients hospitalised with COVID-19 were similar to those among community controls without COVID-19. ",

keywords = "COVID-19, Cohort, Dyspnoea, Long COVID, Recovery",

author = "{PHOSP-COVID Study Collaborative Group} and Bang Zheng and Giulia Vivaldi and Luke Daines and Leavy, {Olivia C} and Matthew Richardson and Omer Elneima and McAuley, {Hamish J C} and Aarti Shikotra and Amisha Singapuri and Marco Sereno and Saunders, {Ruth M} and Harris, {Victoria C} and Linzy Houchen-Wolloff and Greening, {Neil J} and Peffer, {Paul E} and Hurst, {John R.} and Brown, {Jeremy S} and Manu Shankar-Hari and Carlos Echevarria and {De Soyza}, Anthony and Harrison, {Ewen M} and Docherty, {Annemarie B} and Lone, {Nazir I} and Quint, {Jennifer K} and Chalmers, {James D} and Ling-Pei Ho and Alex Horsley and Marks, {Michael P} and Krishna Poinasamy and Betty Raman and Heaney, {Liam G} and Wain, {Louise V} and Evans, {Rachael A} and Brightling, {Christopher E} and Martineau, {Adrian R.} and Aziz Sheikh",

note = "Funding Information: COVIDENCE UK: We thank all participants of COVIDENCE UK, and the following organisations who supported study recruitment: Asthma UK/British Lung Foundation, the British Heart Foundation, the British Obesity Society, Cancer Research UK, Diabetes UK, Future Publishing, Kidney Care UK, Kidney Wales, Mumsnet, the National Kidney Federation, the National Rheumatoid Arthritis Society, the North West London Health Research Register (DISCOVER), Primary Immunodeficiency UK, the Race Equality Foundation, SWM Health, the Terence Higgins Trust, and Vasculitis UK. Funding Information: PHOSP-COVID is supported by a grant from the MRC-UK Research and Innovation and the Department of Health and Social Care through the National Institute for Health Research (NIHR) rapid response panel to tackle COVID-19. The views expressed in the publication are those of the author(s) and not necessarily those of the National Health Service (NHS), the NIHR or the Department of Health and Social Care. Publisher Copyright: {\textcopyright} 2023 The Author(s)",

year = "2023",

month = jun,

doi = "10.1016/j.lanepe.2023.100635",

language = "English",

volume = "29",

journal = "The Lancet Regional Health - Europe",

issn = "2666-7762",

publisher = "Elsevier Ltd",

}

PHOSP-COVID Study Collaborative Group, Zheng, B, Vivaldi, G, Daines, L, Leavy, OC, Richardson, M, Elneima, O, McAuley, HJC, Shikotra, A, Singapuri, A, Sereno, M, Saunders, RM, Harris, VC, Houchen-Wolloff, L, Greening, NJ, Peffer, PE, Hurst, JR, Brown, JS, Shankar-Hari, M, Echevarria, C, De Soyza, A, Harrison, EM , Docherty, AB , Lone, NI, Quint, JK, Chalmers, JD, Ho, L-P, Horsley, A, Marks, MP, Poinasamy, K, Raman, B, Heaney, LG, Wain, LV, Evans, RA, Brightling, CE, Martineau, AR & Sheikh, A 2023, 'Determinants of recovery from post-COVID-19 dyspnoea: analysis of UK prospective cohorts of hospitalised COVID-19 patients and community-based controls', The Lancet Regional Health - Europe, vol. 29, 100635. https://doi.org/10.1016/j.lanepe.2023.100635

TY - JOUR

T1 - Determinants of recovery from post-COVID-19 dyspnoea: analysis of UK prospective cohorts of hospitalised COVID-19 patients and community-based controls

AU - PHOSP-COVID Study Collaborative Group

AU - Zheng, Bang

AU - Vivaldi, Giulia

AU - Daines, Luke

AU - Leavy, Olivia C

AU - Richardson, Matthew

AU - Elneima, Omer

AU - McAuley, Hamish J C

AU - Shikotra, Aarti

AU - Singapuri, Amisha

AU - Sereno, Marco

AU - Saunders, Ruth M

AU - Harris, Victoria C

AU - Houchen-Wolloff, Linzy

AU - Greening, Neil J

AU - Peffer, Paul E

AU - Hurst, John R.

AU - Brown, Jeremy S

AU - Shankar-Hari, Manu

AU - Echevarria, Carlos

AU - De Soyza, Anthony

AU - Harrison, Ewen M

AU - Docherty, Annemarie B

AU - Lone, Nazir I

AU - Quint, Jennifer K

AU - Chalmers, James D

AU - Ho, Ling-Pei

AU - Horsley, Alex

AU - Marks, Michael P

AU - Poinasamy, Krishna

AU - Raman, Betty

AU - Heaney, Liam G

AU - Wain, Louise V

AU - Evans, Rachael A

AU - Brightling, Christopher E

AU - Martineau, Adrian R.

AU - Sheikh, Aziz

N1 - Funding Information: COVIDENCE UK: We thank all participants of COVIDENCE UK, and the following organisations who supported study recruitment: Asthma UK/British Lung Foundation, the British Heart Foundation, the British Obesity Society, Cancer Research UK, Diabetes UK, Future Publishing, Kidney Care UK, Kidney Wales, Mumsnet, the National Kidney Federation, the National Rheumatoid Arthritis Society, the North West London Health Research Register (DISCOVER), Primary Immunodeficiency UK, the Race Equality Foundation, SWM Health, the Terence Higgins Trust, and Vasculitis UK. Funding Information: PHOSP-COVID is supported by a grant from the MRC-UK Research and Innovation and the Department of Health and Social Care through the National Institute for Health Research (NIHR) rapid response panel to tackle COVID-19. The views expressed in the publication are those of the author(s) and not necessarily those of the National Health Service (NHS), the NIHR or the Department of Health and Social Care. Publisher Copyright: © 2023 The Author(s)

PY - 2023/6

Y1 - 2023/6

N2 - Background The risk factors for recovery from COVID-19 dyspnoea are poorly understood. We investigated determinants of recovery from dyspnoea in adults with COVID-19 and compared these to determinants of recovery from non-COVID-19 dyspnoea. Methods We used data from two prospective cohort studies: PHOSP-COVID (patients hospitalised between March 2020 and April 2021 with COVID-19) and COVIDENCE UK (community cohort studied over the same time period). PHOSP-COVID data were collected during hospitalisation and at 5-month and 1-year follow-up visits. COVIDENCE UK data were obtained through baseline and monthly online questionnaires. Dyspnoea was measured in both cohorts with the Medical Research Council Dyspnoea Scale. We used multivariable logistic regression to identify determinants associated with a reduction in dyspnoea between 5-month and 1-year follow-up.Findings We included 990 PHOSP-COVID and 3309 COVIDENCE UK participants. We observed higher odds of improvement between 5-month and 1-year among PHOSP-COVID participants who were younger (odds ratio 1.02 per year, 95% CI 1.01–1.03), male (1.54, 1.16–2.04), neither obese nor severely obese (1.82, 1.06–3.13 and 4.19, 2.14–8.19, respectively), had no pre-existing anxiety/depression (1.56, 1.09–2.22) or cardiovascular disease (1.33, 1.00–1.79), and shorter hospital admission (1.01 per day, 1.00–1.02). Similar associations were found in those recovering from non-COVID-19 dyspnoea, excluding age (and length of hospital admission).Interpretation Factors associated with dyspnoea recovery at 1-year post-discharge among patients hospitalised with COVID-19 were similar to those among community controls without COVID-19.

AB - Background The risk factors for recovery from COVID-19 dyspnoea are poorly understood. We investigated determinants of recovery from dyspnoea in adults with COVID-19 and compared these to determinants of recovery from non-COVID-19 dyspnoea. Methods We used data from two prospective cohort studies: PHOSP-COVID (patients hospitalised between March 2020 and April 2021 with COVID-19) and COVIDENCE UK (community cohort studied over the same time period). PHOSP-COVID data were collected during hospitalisation and at 5-month and 1-year follow-up visits. COVIDENCE UK data were obtained through baseline and monthly online questionnaires. Dyspnoea was measured in both cohorts with the Medical Research Council Dyspnoea Scale. We used multivariable logistic regression to identify determinants associated with a reduction in dyspnoea between 5-month and 1-year follow-up.Findings We included 990 PHOSP-COVID and 3309 COVIDENCE UK participants. We observed higher odds of improvement between 5-month and 1-year among PHOSP-COVID participants who were younger (odds ratio 1.02 per year, 95% CI 1.01–1.03), male (1.54, 1.16–2.04), neither obese nor severely obese (1.82, 1.06–3.13 and 4.19, 2.14–8.19, respectively), had no pre-existing anxiety/depression (1.56, 1.09–2.22) or cardiovascular disease (1.33, 1.00–1.79), and shorter hospital admission (1.01 per day, 1.00–1.02). Similar associations were found in those recovering from non-COVID-19 dyspnoea, excluding age (and length of hospital admission).Interpretation Factors associated with dyspnoea recovery at 1-year post-discharge among patients hospitalised with COVID-19 were similar to those among community controls without COVID-19.

KW - COVID-19

KW - Cohort

KW - Dyspnoea

KW - Long COVID

KW - Recovery

U2 - 10.1016/j.lanepe.2023.100635

DO - 10.1016/j.lanepe.2023.100635

M3 - Article

C2 - 37261214

SN - 2666-7762

VL - 29

JO - The Lancet Regional Health - Europe

JF - The Lancet Regional Health - Europe

M1 - 100635

ER -

Determinants of recovery from post-COVID-19 dyspnoea: analysis of UK prospective cohorts of hospitalised COVID-19 patients and community-based controls

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