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 PaO2/FiO2 (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.

Lombardi, F., Calabrese, A. C., Iovene, B., Pierandrei, C., Lerede, M., Varone, F., Richeldi, L., Sgalla, G., Landi, F., Gremese, E., Bernabei, R., Fantoni, M., Gasbarrini, A., Romano Settanni, C., Benvenuto, F., Bramato, G., Carfi, A., Ciciarello, F., Lo Monaco, M. R., Maria Martone, A., Marzetti, E., Napolitano, C., Pagano, F. C., Rocchi, S., Rota, E., Salerno, A. M., Tosato, M., Tritto, M., Calvani, R., Catalano, L., Picca, A., Savera, G., Tamburrini, E., Borghetti, A., Di Gianbenedetto, S., Murri, R., Cingolani, A., Ventura, G., Taddei, E., Moschese, D., Ciccullo, A., Stella, L., Addolorato, G., Franceschi, F., Mingrone, G., Assunta Zocco, M., Sanguinetti, M., Cattani Franchi, P., Marchetti, S., Bizzarro, A., Lauria, A., Rizzo, S., Cristina Savastano, M., Gambini, G., Grazia Cozzupoli, M., Culiersi, C., Passali, G. C., Paludetti, G., Galli, J., Crudo, F., Di Cintio, G., Longobardi, Y., Tricarico, L., Santantonio, M., Buonsenso, D., Valentini, P., Pata, D., Sinatti, D., De Rose, C., Calabrese, A. C., Sani, G., Janiri, D., Giuseppin, G., Molinaro, M., Modica, M., Natale, L., Rita Larici, A., Marano, R., Paglionico, A., Petricca, L., Gigante, L., Natalello, G., Laur, A. F. A., Maria Lizzio, M., Santoliquido, A., Santoro, L., Nesci, A., Popolla, V., Residual respiratory impairment after COVID-19 pneumonia, <<BMC PULMONARY MEDICINE>>, 2021; 21 (1): 241-248. [doi:10.1186/s12890-021-01594-4] [https://hdl.handle.net/10807/231036]

Residual respiratory impairment after COVID-19 pneumonia

Calabrese, Anna Chiara;Iovene, Bruno;Varone, Francesco;Richeldi, Luca;Sgalla, Giacomo;Landi, Francesco;Gremese, Elisa;Bernabei, Roberto;Fantoni, Massimo;Gasbarrini, Antonio;Bramato, Giulia;Ciciarello, Francesca;Lo Monaco, Maria Rita;Marzetti, Emanuele;Pagano, Francesco Cosimo;Rocchi, Sara;Salerno, Andrea Maria;Tosato, Matteo;Calvani, Riccardo;Catalano, Lucio;Savera, Giulia;Tamburrini, Enrica;Borghetti, Alberto;Murri, Rita;Cingolani, Antonella;Ventura, Giulio;Addolorato, Giovanni;Franceschi, Francesco;Mingrone, Geltrude;Sanguinetti, Maurizio;Cattani Franchi, Paola;Marchetti, Simona;Bizzarro, Alessandra;Lauria, Alessandra;Rizzo, Stanislao;Gambini, Gloria;Culiersi, Carola;Passali, Giulio Cesare;Paludetti, Gaetano;Galli, Jacopo;Longobardi, Ylenia;Tricarico, Laura;Buonsenso, Danilo;Valentini, Piero;Sinatti, Dario;De Rose, Cristina;Calabrese, Anna Chiara;Sani, Gabriele;Janiri, Delfina;Modica, Marco;Natale, Luigi;Marano, Riccardo;Petricca, Luca;Gigante, Lavinia;Santoliquido, Angelo;Popolla, Valentina
2021

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 PaO2/FiO2 (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.
2021
Inglese
Lombardi, F., Calabrese, A. C., Iovene, B., Pierandrei, C., Lerede, M., Varone, F., Richeldi, L., Sgalla, G., Landi, F., Gremese, E., Bernabei, R., Fantoni, M., Gasbarrini, A., Romano Settanni, C., Benvenuto, F., Bramato, G., Carfi, A., Ciciarello, F., Lo Monaco, M. R., Maria Martone, A., Marzetti, E., Napolitano, C., Pagano, F. C., Rocchi, S., Rota, E., Salerno, A. M., Tosato, M., Tritto, M., Calvani, R., Catalano, L., Picca, A., Savera, G., Tamburrini, E., Borghetti, A., Di Gianbenedetto, S., Murri, R., Cingolani, A., Ventura, G., Taddei, E., Moschese, D., Ciccullo, A., Stella, L., Addolorato, G., Franceschi, F., Mingrone, G., Assunta Zocco, M., Sanguinetti, M., Cattani Franchi, P., Marchetti, S., Bizzarro, A., Lauria, A., Rizzo, S., Cristina Savastano, M., Gambini, G., Grazia Cozzupoli, M., Culiersi, C., Passali, G. C., Paludetti, G., Galli, J., Crudo, F., Di Cintio, G., Longobardi, Y., Tricarico, L., Santantonio, M., Buonsenso, D., Valentini, P., Pata, D., Sinatti, D., De Rose, C., Calabrese, A. C., Sani, G., Janiri, D., Giuseppin, G., Molinaro, M., Modica, M., Natale, L., Rita Larici, A., Marano, R., Paglionico, A., Petricca, L., Gigante, L., Natalello, G., Laur, A. F. A., Maria Lizzio, M., Santoliquido, A., Santoro, L., Nesci, A., Popolla, V., Residual respiratory impairment after COVID-19 pneumonia, <<BMC PULMONARY MEDICINE>>, 2021; 21 (1): 241-248. [doi:10.1186/s12890-021-01594-4] [https://hdl.handle.net/10807/231036]
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