Obesity: how pulmonary function tests may let us down

Neder, J. Alberto; Berton, Danilo Cortozi; O'Donnell, Denis E

doi:10.36416/1806-3756/e20200116

Cited by 5 publications

(2 citation statements)

References 5 publications

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“…On average, VC was reduced by about 15% which would mean Vi should have been reduced by about 5%, but it was reduced by around 15% which suggests more than an obesity effect. It is understood that there is an increase in capillary blood volume in obesity that is thought to lead to the increase in gas transfer [22].…”

Section: Discussionmentioning

confidence: 99%

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Lung Function and Breathing Patterns in Hospitalised COVID-19 Survivors: a Review of Post-COVID-19 Clinics

Stockley¹,

Alhuthail

Coney

et al. 2021

Preprint

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Introduction: There is relatively little published on the effects of COVID-19 on respiratory physiology, particularly breathing patterns. We sought to determine if there were lasting detrimental effect following hospital discharge and if these related to the severity of COVID-19.Methods: We reviewed lung function and breathing patterns in COVID-19 survivors >3 months after discharge, comparing patients who had been admitted to the intensive therapy unit (ITU) (n=47) to those who just received ward treatments (n=45). Lung function included spirometry and gas transfer and breathing patterns were measured with structured light plethysmography. Continuous data were compared with an independent t-test or Mann Whitney-U test (depending on distribution) and nominal data were compared using a Fisher’s exact test (for 2 categories in 2 groups) or a chi-squared test (for >2 categories in 2 groups). A p-value of < 0.05 was taken to be statistically significant.Results: We found evidence of pulmonary restriction (reduced vital capacity and/or alveolar volume) in 65.4% of all patients. 36.1% of all patients has a reduced transfer factor (TLCO) but the majority of these (78.1%) had a preserved/increased transfer coefficient (KCO), suggesting an extrapulmonary cause. There were no major differences between ITU and ward lung function although KCO alone was higher in the ITU patients (p = 0.03). This could be explained partly by obesity, respiratory muscle fatigue, localised microvascular changes, or haemosiderosis from lung damage. Abnormal breathing patterns were observed in 18.8% of subjects, although no consistent pattern of breathing pattern abnormalities was evident.Conclusions: An “extrapulmonary restrictive” like pattern appears to be a common phenomenon in previously admitted COVID-19 survivors. Whilst the cause of this is not clear, the effects seem to be similar on patients whether or not they received mechanical ventilation or had ward based respiratory support/supplemental oxygen.

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Section: Discussionmentioning

confidence: 99%

“…Incomplete alveolar expansion but preserved gas exchange unities frequently lead to K CO > 120-140% or even higher (i.e. extra-parenchymal restriction, such as pleural, chest wall or neuromuscular disease) [21][22][23][24]. Pleural changes have been identi ed in COVID-19 patients using imaging [25][26][27][28][29] and at autopsy [30].…”

Section: Discussionmentioning

confidence: 99%

Lung Function and Breathing Patterns in Hospitalised COVID-19 Survivors: a Review of Post-COVID-19 Clinics

Stockley¹,

Alhuthail

Coney

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

Predictors of methacholine challenge testing results in subjects without airflow obstruction

2021

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Lung function and breathing patterns in hospitalised COVID-19 survivors: a review of post-COVID-19 Clinics

et al. 2021

View full text Add to dashboard Cite

Introduction There is relatively little published on the effects of COVID-19 on respiratory physiology, particularly breathing patterns. We sought to determine if there were lasting detrimental effect following hospital discharge and if these related to the severity of COVID-19. Methods We reviewed lung function and breathing patterns in COVID-19 survivors > 3 months after discharge, comparing patients who had been admitted to the intensive therapy unit (ITU) (n = 47) to those who just received ward treatments (n = 45). Lung function included spirometry and gas transfer and breathing patterns were measured with structured light plethysmography. Continuous data were compared with an independent t-test or Mann Whitney-U test (depending on distribution) and nominal data were compared using a Fisher’s exact test (for 2 categories in 2 groups) or a chi-squared test (for > 2 categories in 2 groups). A p-value of < 0.05 was taken to be statistically significant. Results We found evidence of pulmonary restriction (reduced vital capacity and/or alveolar volume) in 65.4% of all patients. 36.1% of all patients has a reduced transfer factor (TLCO) but the majority of these (78.1%) had a preserved/increased transfer coefficient (KCO), suggesting an extrapulmonary cause. There were no major differences between ITU and ward lung function, although KCO alone was higher in the ITU patients (p = 0.03). This could be explained partly by obesity, respiratory muscle fatigue, localised microvascular changes, or haemosiderosis from lung damage. Abnormal breathing patterns were observed in 18.8% of subjects, although no consistent pattern of breathing pattern abnormalities was evident. Conclusions An “extrapulmonary restrictive” like pattern appears to be a common phenomenon in previously admitted COVID-19 survivors. Whilst the cause of this is not clear, the effects seem to be similar on patients whether or not they received mechanical ventilation or had ward based respiratory support/supplemental oxygen.

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Obesity: how pulmonary function tests may let us down

Cited by 5 publications

References 5 publications

Lung Function and Breathing Patterns in Hospitalised COVID-19 Survivors: a Review of Post-COVID-19 Clinics

Lung Function and Breathing Patterns in Hospitalised COVID-19 Survivors: a Review of Post-COVID-19 Clinics

Predictors of methacholine challenge testing results in subjects without airflow obstruction

Lung function and breathing patterns in hospitalised COVID-19 survivors: a review of post-COVID-19 Clinics

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