Background
The evaluation of COVID‐19 systemic consequences is a wide research field in which respiratory function assessment has a pivotal role. However, the available data in the literature are still sparse and need further strengthening.
Aim
To assess respiratory function 4–6 months after hospital discharge based on lung disease severity in patients who overcome COVID‐19 pneumonia.
Methods
Patients hospitalised either in the Internal Medicine Department (IMD) for moderate to severe disease or in the Intensive Care Unit (ICU) for critical disease underwent spirometry with maximal flow‐volume curve, lung volumes, lung diffusion capacity (DL
CO
) and six‐minute walking test (6‐MWT).
Results
Eighty‐eight patients were analysed: 40 from the IMD and 48 from the ICU. In both cohorts, there was a greater prevalence of male patients. In the IMD cohort, 38% of patients showed at least one altered respiratory parameter, while 62% in the ICU cohort did so (
P
< 0.05). Total lung capacity (TLC) and DL
CO
were the most frequently altered parameters: 15% and 33% from IMD versus 33% and 56% from ICU, respectively (
P
< 0.05). In IMD patients, 5% had only restrictive deficit, 22% had only lung diffusion impairment and 10% had both. In ICU patients, 6% had only restrictive deficit, 29% had only lung diffusion impairment and 27% had both (
P
< 0.05). ICU patients showed a higher frequency of abnormal 6‐MWT (
P
< 0.05).
Conclusion
Lung function tests and 6‐MWT are highly informative tools for monitoring the negative consequences of COVID‐19 pneumonia, which were more frequent and more complex in patients discharged from ICU.
Rationale: Among the main consequences caused by SARS-COV2 pneumonia respiratory function impairment is one of the most representative. Objectives: The study aims to evaluate the respiratory function in a cohort of patients who had SARS-COV-2 pneumonia. Methods: 88 patients were analyzed at 4-6 months after hospital discharge. 40 had been admitted to Internal Medicine Department (IMD), and 48 to Intensive Care Unit (ICU) for mild-moderate and severe form of disease respectively. Patients underwent spirometry with maximal flow-volume curve and lung volumes and diffusion lung capacity (DL CO ) measurements. Results: In the IMD cohort, 38% of patients showed at least one altered respiratory function parameter. In the ICU discharged cohort, 62% showed at least one altered parameter (p<0.01). In both cohorts, DL CO was the most frequently altered parameter (33% of the IMD patients and 50% of the ICU ones). Next, 3 groups have been created: patients with only Total Lung Capacity (TLC) < 80% pred.; patients with DLCO < 80% pred.; patients with both TLC and DLCO < 80% pred. In patients discharged from the IMD, 5% had only restrictive deficit, 20% had only lung diffusion impairment, and 10% had both issues. In patients discharged from the ICU, 8% had only restrictive deficit, 27% had only lung diffusion impairment, and 23% showed both issues. Overall, at 4-6 months from hospital discharge, 38% of patients completely recovered after severe SARS-COV-2 pneumonia. The coexistence of both restrictive deficit and lung diffusion impairment was more frequent in patients discharged from ICU. Conclusion: In order to provide an accurate evaluation of the residual respiratory function in patients who had SARS-COV2 pneumonia, follow-up protocols with lung function tests are suggested and should be implemented in routine practice.
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