COVID-19 potentially causes long-term deterioration of lung function: a systematic review and meta-analysis

Abstract

BACKGROUND The COVID-19 is an emerging disease that commonly involves respiratory complaints, including acute respiratory distress syndrome. The effect of COVID-19 on pulmonary function is still unclear and only based on sporadic reports with a small sample size. This study aimed to compile evidence on the pulmonary function of patients who have recovered from COVID-19.
 METHODS Literature searching was conducted in PubMed, Embase, Google Scholar, Scopus, Web of Sciences, and CINAHL. Any types of studies published before June 26, 2020 and reported lung function tests of post-COVID-19 patients were included. Articles reporting data from early hospitalization were excluded. The risk of bias was measured using tools developed by the Joanna Briggs Institute. Meta-analysis was done using a meta statistical package in R and presented in the random effects model.
 RESULTS 378 recovered COVID-19 patients in 7 studies were included. The lung function measurement periods were varied, ranging from 14 days after hospitalization to 10 weeks after receiving rehabilitation. Meta-analyses found that the pooled mean of diffusion capacity of carbon monoxide in recovered COVID-19 patients was lower than 80% predicted, whereas the other parameters were normal. The forced vital capacity and total lung capacity showing restrictive lung disorders were significantly lower in the severe COVID-19 survivors.
 CONCLUSIONS COVID-19 has a negative impact on lung function for at least several weeks in the recovery period. Diffusion and restrictive problems could be the main long-term consequences of COVID-19.

Correlation between C-Reactive Protein (CRP) and lymphocyte levels in the acute phase with spirometry test in severe Coronavirus Disease 2019 (COVID-19) survivors after twelve weeks

“…In the spirometry calculation in this study, most of the patients with a history of severe COVID-19 were more than 16 weeks, and it was found that the FEF1/FVC value was greater than 75 in 87.5% of respondents, and only 12.5% had a value below 75. This is similar to a meta-analysis conducted to assess lung function in COVID-19 survivors, where normal lung function values were found in COVID-19 patients, indicating no significant change in lung function in COVID-19 survivors from 14 days after being declared healed (Patria and Sabirin, 2021). However, different results were found in a follow-up study one year after recovery from COVID-19, which showed functional lung impairment was widespread in COVID-19 survivors one year after discharge from the hospital, and persistent lung function impairment was found in about 40 patients.…”

“…High inflammation in the acute phase can cause damage to lung tissue in the form of fibrosis, which can cause symptoms after COVID-19 infection in the form of shortness of breath. Studies on the increase in CRP and lymphopenia in the acute phase to the symptoms experienced by COVID-19 survivors are still limited (Bazdyrev et al, 2021;Patria and Sabirin, 2021;Zhao et al, 2021) Spirometry is one of the tests to assess lung function. The results can determine the presence of pulmonary function disorders in obstruction, restrictive or mixed.…”