tetano
Editor, Senior Moderator
Respiration
. 2021 Aug 19;1-10.
doi: 10.1159/000518141. Online ahead of print.
Six-Month Pulmonary Impairment after Severe COVID-19: A Prospective, Multicentre Follow-Up Study
Paola Faverio[SUP] 1 [/SUP], Fabrizio Luppi[SUP] 1 [/SUP], Paola Rebora[SUP] 2 [/SUP], Sara Busnelli[SUP] 1 [/SUP], Anna Stainer[SUP] 1 [/SUP], Martina Catalano[SUP] 1 [/SUP], Luca Parachini[SUP] 1 [/SUP], Anna Monzani[SUP] 1 [/SUP], Stefania Galimberti[SUP] 2 [/SUP], Francesco Bini[SUP] 3 [/SUP], Bruno Dino Bodini[SUP] 3 [/SUP], Monia Betti[SUP] 4 [/SUP], Federica De Giacomi[SUP] 4 [/SUP], Paolo Scarpazza[SUP] 5 [/SUP], Elisa Oggionni[SUP] 5 [/SUP], Alessandro Scartabellati[SUP] 6 [/SUP], Luca Bilucaglia[SUP] 6 [/SUP], Paolo Ceruti[SUP] 7 [/SUP], Denise Modina[SUP] 7 [/SUP], Sergio Harari[SUP] 8 [/SUP], Antonella Caminati[SUP] 9 [/SUP], Maria Grazia Valsecchi[SUP] 2 [/SUP], Giacomo Bellani[SUP] 10 [/SUP], Giuseppe Foti[SUP] 10 [/SUP], Alberto Pesci[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Long-term pulmonary sequelae following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia are not yet confirmed; however, preliminary observations suggest a possible relevant clinical, functional, and radiological impairment.
Objectives: The aim of this study was to identify and characterize pulmonary sequelae caused by SARS-CoV-2 pneumonia at 6-month follow-up.
Methods: In this multicentre, prospective, observational cohort study, patients hospitalized for SARS-CoV-2 pneumonia and without prior diagnosis of structural lung diseases were stratified by maximum ventilatory support ("oxygen only," "continuous positive airway pressure," and "invasive mechanical ventilation") and followed up at 6 months from discharge. Pulmonary function tests and diffusion capacity for carbon monoxide (DLCO), 6-min walking test, chest X-ray, physical examination, and modified Medical Research Council (mMRC) dyspnoea score were collected.
Results: Between March and June 2020, 312 patients were enrolled (83, 27% women; median interquartile range age 61.1 [53.4, 69.3] years). The parameters that showed the highest rate of impairment were DLCO and chest X-ray, in 46% and 25% of patients, respectively. However, only a minority of patients reported dyspnoea (31%), defined as mMRC ≥1, or showed restrictive ventilatory defects (9%). In the logistic regression model, having asthma as a comorbidity was associated with DLCO impairment at follow-up, while prophylactic heparin administration during hospitalization appeared as a protective factor. The need for invasive ventilatory support during hospitalization was associated with chest imaging abnormalities.
Conclusions: DLCO and radiological assessment appear to be the most sensitive tools to monitor patients with the coronavirus disease 2019 (COVID-19) during follow-up. Future studies with longer follow-up are warranted to better understand pulmonary sequelae.
Keywords: COVID-19; Follow-up; Pneumonia; Pulmonary fibrosis; Radiology and other imaging; Respiratory function tests.
. 2021 Aug 19;1-10.
doi: 10.1159/000518141. Online ahead of print.
Six-Month Pulmonary Impairment after Severe COVID-19: A Prospective, Multicentre Follow-Up Study
Paola Faverio[SUP] 1 [/SUP], Fabrizio Luppi[SUP] 1 [/SUP], Paola Rebora[SUP] 2 [/SUP], Sara Busnelli[SUP] 1 [/SUP], Anna Stainer[SUP] 1 [/SUP], Martina Catalano[SUP] 1 [/SUP], Luca Parachini[SUP] 1 [/SUP], Anna Monzani[SUP] 1 [/SUP], Stefania Galimberti[SUP] 2 [/SUP], Francesco Bini[SUP] 3 [/SUP], Bruno Dino Bodini[SUP] 3 [/SUP], Monia Betti[SUP] 4 [/SUP], Federica De Giacomi[SUP] 4 [/SUP], Paolo Scarpazza[SUP] 5 [/SUP], Elisa Oggionni[SUP] 5 [/SUP], Alessandro Scartabellati[SUP] 6 [/SUP], Luca Bilucaglia[SUP] 6 [/SUP], Paolo Ceruti[SUP] 7 [/SUP], Denise Modina[SUP] 7 [/SUP], Sergio Harari[SUP] 8 [/SUP], Antonella Caminati[SUP] 9 [/SUP], Maria Grazia Valsecchi[SUP] 2 [/SUP], Giacomo Bellani[SUP] 10 [/SUP], Giuseppe Foti[SUP] 10 [/SUP], Alberto Pesci[SUP] 1 [/SUP]
Affiliations
- PMID: 34515212
- DOI: 10.1159/000518141
Abstract
Background: Long-term pulmonary sequelae following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia are not yet confirmed; however, preliminary observations suggest a possible relevant clinical, functional, and radiological impairment.
Objectives: The aim of this study was to identify and characterize pulmonary sequelae caused by SARS-CoV-2 pneumonia at 6-month follow-up.
Methods: In this multicentre, prospective, observational cohort study, patients hospitalized for SARS-CoV-2 pneumonia and without prior diagnosis of structural lung diseases were stratified by maximum ventilatory support ("oxygen only," "continuous positive airway pressure," and "invasive mechanical ventilation") and followed up at 6 months from discharge. Pulmonary function tests and diffusion capacity for carbon monoxide (DLCO), 6-min walking test, chest X-ray, physical examination, and modified Medical Research Council (mMRC) dyspnoea score were collected.
Results: Between March and June 2020, 312 patients were enrolled (83, 27% women; median interquartile range age 61.1 [53.4, 69.3] years). The parameters that showed the highest rate of impairment were DLCO and chest X-ray, in 46% and 25% of patients, respectively. However, only a minority of patients reported dyspnoea (31%), defined as mMRC ≥1, or showed restrictive ventilatory defects (9%). In the logistic regression model, having asthma as a comorbidity was associated with DLCO impairment at follow-up, while prophylactic heparin administration during hospitalization appeared as a protective factor. The need for invasive ventilatory support during hospitalization was associated with chest imaging abnormalities.
Conclusions: DLCO and radiological assessment appear to be the most sensitive tools to monitor patients with the coronavirus disease 2019 (COVID-19) during follow-up. Future studies with longer follow-up are warranted to better understand pulmonary sequelae.
Keywords: COVID-19; Follow-up; Pneumonia; Pulmonary fibrosis; Radiology and other imaging; Respiratory function tests.