This prospective cohort study evaluated whether early inflammatory phenotypes — identified within 24 hours of ICU admission using a 65-plex biomarker panel and k-means clustering — predicted long-term pulmonary outcomes (DLCO, TLC, FEV1, MIP) at 6 and 12 months in adults hospitalized with COVID-19.
Two phenotypes emerged (ThHigh vs. ThLow). At 12 months, ThHigh patients had significantly higher DLCO (β = 9.44; 95% CI 4.36–14.52) but lower FEV1 (β = −4.05; 95% CI −7.91 to −0.19) than ThLow patients; TLC and MIP did not differ significantly between groups.
Sample size is not reported in the abstract, limiting assessment of statistical power. The study is restricted to ICU-admitted patients, so findings may not generalize to non-ICU COVID-19 cases. The 65-plex biomarker panel is not standard clinical practice, which may limit immediate implementability.
Early inflammatory profiling at ICU admission may identify COVID-19 patients at risk for persistent airflow limitation (lower FEV1) or diffusion impairment (lower DLCO) up to 12 months post-discharge, supporting targeted follow-up. Clinicians should consider structured pulmonary function surveillance for high-inflammatory phenotype patients after severe COVID-19.
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