tetano
Editor, Senior Moderator
BMC Pulm Med
. 2021 Jul 17;21(1):241.
doi: 10.1186/s12890-021-01594-4.
Residual respiratory impairment after COVID-19 pneumonia
Francesco Lombardi[SUP] 1 2 [/SUP], Angelo Calabrese[SUP] 1 2 [/SUP], Bruno Iovene[SUP] 1 [/SUP], Chiara Pierandrei[SUP] 2 [/SUP], Marialessia Lerede[SUP] 2 [/SUP], Francesco Varone[SUP] 1 [/SUP], Luca Richeldi[SUP] 1 2 [/SUP], Giacomo Sgalla[SUP] 3 [/SUP], Gemelli Against COVID-19 Post-Acute Care Study Group
Collaborators, Affiliations
Abstract
Introduction: The novel coronavirus SARS-Cov-2 can infect the respiratory tract causing a spectrum of disease varying from mild to fatal pneumonia, and known as COVID-19. Ongoing clinical research is assessing the potential for long-term respiratory sequelae in these patients. We assessed the respiratory function in a cohort of patients after recovering from SARS-Cov-2 infection, stratified according to PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] (p/F) values.
Method: Approximately one month after hospital discharge, 86 COVID-19 patients underwent physical examination, arterial blood gas (ABG) analysis, pulmonary function tests (PFTs), and six-minute walk test (6MWT). Patients were also asked to quantify the severity of dyspnoea and cough before, during, and after hospitalization using a visual analogic scale (VAS). Seventy-six subjects with ABG during hospitalization were stratified in three groups according to their worst p/F values: above 300 (n = 38), between 200 and 300 (n = 30) and below 200 (n = 20).
Results: On PFTs, lung volumes were overall preserved yet, mean percent predicted residual volume was slightly reduced (74.8 ± 18.1%). Percent predicted diffusing capacity for carbon monoxide (DLCO) was also mildly reduced (77.2 ± 16.5%). Patients reported residual breathlessness at the time of the visit (VAS 19.8, p < 0.001). Patients with p/F below 200 during hospitalization had lower percent predicted forced vital capacity (p = 0.005), lower percent predicted total lung capacity (p = 0.012), lower DLCO (p < 0.001) and shorter 6MWT distance (p = 0.004) than patients with higher p/F.
Conclusion: Approximately one month after hospital discharge, patients with COVID-19 can have residual respiratory impairment, including lower exercise tolerance. The extent of this impairment seems to correlate with the severity of respiratory failure during hospitalization.
Keywords: 6MWT; ABG; COVID; PFT; cough; dyspnoea.
. 2021 Jul 17;21(1):241.
doi: 10.1186/s12890-021-01594-4.
Residual respiratory impairment after COVID-19 pneumonia
Francesco Lombardi[SUP] 1 2 [/SUP], Angelo Calabrese[SUP] 1 2 [/SUP], Bruno Iovene[SUP] 1 [/SUP], Chiara Pierandrei[SUP] 2 [/SUP], Marialessia Lerede[SUP] 2 [/SUP], Francesco Varone[SUP] 1 [/SUP], Luca Richeldi[SUP] 1 2 [/SUP], Giacomo Sgalla[SUP] 3 [/SUP], Gemelli Against COVID-19 Post-Acute Care Study Group
Collaborators, Affiliations
- PMID: 34273962
- DOI: 10.1186/s12890-021-01594-4
Abstract
Introduction: The novel coronavirus SARS-Cov-2 can infect the respiratory tract causing a spectrum of disease varying from mild to fatal pneumonia, and known as COVID-19. Ongoing clinical research is assessing the potential for long-term respiratory sequelae in these patients. We assessed the respiratory function in a cohort of patients after recovering from SARS-Cov-2 infection, stratified according to PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] (p/F) values.
Method: Approximately one month after hospital discharge, 86 COVID-19 patients underwent physical examination, arterial blood gas (ABG) analysis, pulmonary function tests (PFTs), and six-minute walk test (6MWT). Patients were also asked to quantify the severity of dyspnoea and cough before, during, and after hospitalization using a visual analogic scale (VAS). Seventy-six subjects with ABG during hospitalization were stratified in three groups according to their worst p/F values: above 300 (n = 38), between 200 and 300 (n = 30) and below 200 (n = 20).
Results: On PFTs, lung volumes were overall preserved yet, mean percent predicted residual volume was slightly reduced (74.8 ± 18.1%). Percent predicted diffusing capacity for carbon monoxide (DLCO) was also mildly reduced (77.2 ± 16.5%). Patients reported residual breathlessness at the time of the visit (VAS 19.8, p < 0.001). Patients with p/F below 200 during hospitalization had lower percent predicted forced vital capacity (p = 0.005), lower percent predicted total lung capacity (p = 0.012), lower DLCO (p < 0.001) and shorter 6MWT distance (p = 0.004) than patients with higher p/F.
Conclusion: Approximately one month after hospital discharge, patients with COVID-19 can have residual respiratory impairment, including lower exercise tolerance. The extent of this impairment seems to correlate with the severity of respiratory failure during hospitalization.
Keywords: 6MWT; ABG; COVID; PFT; cough; dyspnoea.