Abstract:Objective To understand the respiratory system function and health status of patients with coronavirus disease 2019 (COVID-19) after discharge from hospital. Methods COVID-19 patients who admitted to Wuhan Lei Shen Shan Hospital from February to March 2020 were divided into two groups (common group and severe group) according to The diagnosis and treatment protocol for COVID-19 (trial version 7). The general data of patients, baseline clinical characteristics such as smoking history, past history and exercise status, scores of modified Medical Research Council (mMRC), results of 6-minute walking test (6MWT), as well as chest CT findings and scores at discharge were collected. Patients were followed up at 6, 12, 18 and 24 months after discharge, and were inquired whether they still had clinical symptoms of COVID-19. Results 320 patients with COVID-19 were included in the study, 179 (55.9%) in common group and 141 (44.1%) in severe group; 149 (46.6%) were males and 171 (53.4%) were females. Fatigue and sleep disturbance were the most common clinical symptoms at post-discharge follow-up visits, compared with discharge, these symptoms were significantly improved 12 months after discharge(P < 0.05). The 6-minute walking distance (6MWD) of patients in common group was significantly improved at 6 months after discharge, and patients in severe group was significantly improved at 12 months after discharge (both P < 0.05). The most common abnormal manifestations of chest CT were ground glass shadow and fibrosis, by the end of 24 months after discharge, 94.1% (178/185)of the patients had completely absorbed the chest CT lesions. Cox regression analysis showed that independent protective factors for complete absorption of abnormal chest CT findings in COVID-19 patients were as follows: younger age (HR=0.975, 95%CI: 0.963-0.987, P < 0.001), lower disease severity (common/severe group, HR=1.800, 95%CI: 1.255-2.581, P=0.001), higher level exercise (moderate activity/fluctuation, HR=1.432, 95%CI: 1.046-1.961, P=0.025), higher absolute value of baseline lymphocytes (HR=1.126, 95%CI: 1.054-1.202, P < 0.001), and low baseline C-reactive protein level (HR=0.991, 95%CI: 0.982-0.999, P=0.036). Conclusion Most common and severe types of COVID-19 patients recover well at 24-month follow-up, and the recovery of respiratory system function is faster in common group than severe group. Younger age, higher level of physical activity, lower disease severity, higher baseline lymphocyte level and lower baseline C-reactive protein level are all conducive to the complete absorption of lesions shown by chest CT.