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Persistent lung issues are common following hospital discharge for COVID-19, but recovery is more the rule than the exception, according to two studies presented at the .

Among 86 patients admitted for COVID-19 at three hospitals in the Tyrolean Alps from late April through early June, 39% and 15% of patients, respectively, were still experiencing shortness of breath and coughing after 12 weeks, reported Sabrina Sahanic of the University Clinic of Internal Medicine in Innsbruck.

Moreover, 56% showed evidence of COVID-19-related lung damage on CT scans.

"COVID-19 survivors had persistent lung impairment weeks after recovery. Yet, over time, a moderate improvement is detectable," Sahanic said at a press briefing.

That was documented in a second study led by doctoral candidate Yara Al Chikhanie of Grenoble Alps University in France -- another international ski destination -- examining outcomes in 19 patients who had required mechanical ventilation for COVID-19.

The patients spent an average of 3 weeks in the ICU on mechanical ventilators and 2 weeks in the pulmonary unit before transfer to the Dieulefit Sante pulmonary clinic in the French Alps. Most were still not walking when they arrived at the rehabilitation clinic, and they spent an average of 3 weeks there.

On average, pulmonary rehabilitation lasted 21 days. At the start of pulmonary rehabilitation, the participants were able to walk, on average, 16% of the 6-minute walk distance (6MWD) considered normal. Three weeks later, the average distance was 43% of normal.

A strong negative correlation existed between the number of days post-extubation before pulmonary rehabilitation, and the gain in 6MWD.

Al Chikhanie said that patients who started rehabilitation within a week after coming off ventilators had quicker recoveries than those admitted after 2 weeks.

Alpine ski resorts, which draw travelers from all over the world, became early hotspots for COVID-19, with the virus spreading rapidly before people were really aware of how prevalent it had become.

Sahanic's study, which examined patients at 6 and 12 weeks after discharge, also showed that recovery in those with impaired pulmonary and cardiac function was often slow:

• 28% of patients showed forced vital capacity as less than 80% of normal at 6 weeks, improving to 19% at 12 weeks.
• 33% showed carbon monoxide diffusion capacity as less than 80% of normal at 6 weeks, improving to 22% at 12 weeks.
• CT scans showed the score defining severity of overall lung damage decreasing from 8 points at 6 weeks to 4 points at 12 weeks.
• At the 6-week visit, echocardiography showed that 48 patients (58.5%) had dysfunction of the left ventricle of the heart at diastole, which improved over time. Biological indicators of heart damage, blood clots and inflammation were all significantly elevated.

Patients' mean age in the Austrian study was 61; 65% were men, nearly half were current or former smokers, and 65% were overweight or obese. About one-fifth were admitted to an ICU and required mechanical ventilation. Mean hospital stay was 13 days.

In the press briefing, Sahanic said left ventricular diastolic dysfunction may be a sign of disease severity in general, and may not be specific to COVID-19.

"It is clear from both these studies that rehabilitation, including physical and psychologic components, should be available for patients as soon as possible and it should continue for weeks if not months after they have been discharged from hospital in order to give patients the best chances of a good recovery," European Respiratory Society president Thierry Troosters, MD, of the University of Leuven, Belgium, .

"Governments, national health services and employers should be made aware of these findings and plan accordingly."