Dynamics of functional changes in the respiratory system after COVID-19-associated lung injury at one year after hospital discharge

Chernyak, A. V.; Mustafina, M. Kh.; Naumenko, Zh. K.; Kalmanova, E. N.; Zykov, K. A.

doi:10.18093/0869-0189-2023-33-5-611-621

Pulʹmonologiâ (Mosk.)

2023

DOI: 10.18093/0869-0189-2023-33-5-611-621

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Dynamics of functional changes in the respiratory system after COVID-19-associated lung injury at one year after hospital discharge

A. V. Chernyak,

M. Kh. Mustafina,

Zh. K. Naumenko

et al.

Abstract: Morphological examination reveals microcirculation disorders in combination with small areas of lung damage in the long term after COVID-19. Therefore, the function of the respiratory system should be assessed after COVID-19. Aim of this study was to evaluate the dynamics of respiratory dysfunction in patients with COVID-19-associated lung injury using a complex examination of lung function (spirometry, body plethysmography, and lung diffusion testing) one year after hospital discharge. Methods. 60 patients (3… Show more

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2024

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Cited by 3 publications

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Breath assessment at with post-tuberculosis patients suffered new coronavirus infection

Balasaniants,

Abdrakhmanova,

Gilmutdinova

et al. 2024

Russian Family Doctor

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BACKGROUND: The possibility of mutual aggravation of post-tuberculosis and post-COVID respiratory pathologies requires additional consideration. AIM: To study some subjective breathing parameters at patients with post-tuberculosis pulmonary residual changes after a new coronavirus infection recovering. MATERIALS AND METHODS: The study included two groups: the main group — 14 patients with cured pulmonary tuberculosis, who had recovered from a new coronavirus infection, a comparison group — 52 patients with post-tuberculosis changes non-sick new coronavirus infection who were admitted to the tuberculosis sanatorium “Glukhovskaya” in 2020–2021. The severity of shortness of breath using the Modified Medical Research Council (mMRC) and Borg scales was assessed upon admission to the sanatorium and a month later. Results: The mMRC scale was 1.5 ± 1.4 and 2.1 ± 0.2 and the Borg scale was 1.5 ± 1.4 and 2.9 ± 0.2 before treatment respectively in the main group and the comparison group. According to the mMRC scale initially 14.3 and 11.5% of patients with pulmonary tuberculosis and the comparison group did not complain of shortness of breath and 50% of pulmonary tuberculosis patients and 42.4% of the comparison group defined it as severe. After a month there were 3 or 4 points on the mMRC scale among pulmonary tuberculosis patients. In the comparison group 3-point shortness of breath decreased by 11.2 times most often indicated shortness of breath with 2 score. According to the Borg scale dyspnea was initially assessed as 3 points at 71.5% pulmonary tuberculosis patients. In the comparison group 67.3% patients had grade 3 dyspnea and 11.5% noted 4–6 grade shortness of breath. After a month the proportion of patients with mild shortness of breath at the pulmonary tuberculosis and comparison groups increased by 4.5 and 3.3 times, respectively, and the frequency of 3-grade shortness of breath decreased by 5 and 3.9 times. CONCLUSIONS: Major post-tuberculosis changes, smoking and chronic obstructive pulmonary disease determine the severity of breathing discomfort to a greater extent than the experience of new coronavirus infection but rehabilitation treatment are leveled out these differences. It is advisable to study the state of the respiratory system at patients cured of pulmonary tuberculosis.

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Breath assessment at with post-tuberculosis patients suffered new coronavirus infection

Balasaniants,

Abdrakhmanova,

Gilmutdinova

et al. 2024

Russian Family Doctor

View full text Add to dashboard Cite

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Surfactant protein D as a marker of persistent impairment of the lungs diffusion capacity in the long-term period in patients who had suffered from severe COVID-19

Abdullaeva,

Kozhevnikova,

Valiulina

et al. 2024

Medicinskij sovet

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Introduction. The long-term consequences of COVID-19 (СOrona VIrus Disease 2019) for the respiratory system represent a socially significant problem. Long-lasting respiratory symptoms and functional changes in individuals who have suffered coronavirus infection justify the need to study pathogenetic mechanisms. There is little study of epithelial biomarkers and their potential role in the development of long-term respiratory complications.Aim. Тo study the level of the circulating marker surfactant protein- D (SP-D) in patients who suffered severe COVID-19-associated lung damage at 3 and 12 months after the acute form and its relation with indicators of respiratory function.Materials and methods. The study included 70 patients who were examined at 3 and 12 months after the acute phase of COVID-19, which occurred with severe and extremely severe lung damage. Patients underwent a comprehensive study of respiratory function (spirography, bodyplethysmography and diffusion test), a 6-minute step test with quantitative assessment of shortness of breath, both during exercise and in daily life; the study also determined the serum level of surfactant protein-D.Results. The results of the study indicate that 57% of patients who have suffered severe COVID-19-associated lung damage remain persistently impaired in the diffusion capacity of the lungs throughout the year. It was found that the level of SP-D was increased in all patients 3 months after the acute phase of the disease, but in the group with reduced DLco this level was significantly higher after 3 and 12 months (469 ng/ml and 295 ng/ml, respectively).Conclusion. Persistent impairments in the diffusion capacity of the lungs in some patients persist a year after suffering a severe form of COVID-19. Elevated SP-D levels have been found to be associated with decreased lung diffusion capacity. Thus, SP-D can be considered as a potential biomarker of lung injury severity in the long-term period of COVID-19.

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Long-term consequences of the functional state of the respiratory system after SARS-CoV-2-associated lung damage

Savushkina,

Kulagina,

Malashenko

et al. 2024

Bûlletenʹ fiziologii i patologii dyhaniâ

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Aim. To study the dynamics of respiratory system function in patients without a history of bronchopulmonary pathology after SARS-CoV-2 infection with virus-associated lung damage.Materials and methods. A retrospective study was conducted on 29 patients (median age 46 [43-51] years) at two stages: visit 1 (1-4 months) and visit 2 (8-13 months) from the onset of COVID-19. Data from spirometry, bodyplethysmography, diffusion capacity test, impulse oscillometry (IOS), and chest computed tomography (CT) obtained during the acute phase of the disease (CTmax), as well as dyspnea assessed by the mMRC scale, were analyzed.Results. The median CTmax was 75%, and 66% of patients received treatment in the intensive care unit. At visit 1, dyspnea was of mild or moderate severity. Medians of vital capacity (VC), total lung capacity (TLC), residual volume (RV), and diffusion capacity of the lungs (DLco) were reduced (<80% predicted). The median forced expiratory volume in the first second (FEV1) and IOS parameters were within normal ranges. However, increased reactance area (AX) and absolute frequency dependence of resistance (R5–R20) were found in 59% and 24% of cases, respectively. At visit 2, mild dyspnea persisted. Lung volumes were within normal limits, with statistically significant differences between visits. The median DLco was reduced at visit 1 but increased to normal at visit 2, with statistically significant differences between visits. The median IOS parameters remained within normal limits, with no statistically significant differences between visits. However, in visit 1 increased AX and (R5–R20) were observed in 59% and 24%, in visit 2 – 45% and 17% of cases, respectively, with no statistically significant differences between visits.Conclusions. Among the long-term functional consequences of SARS-CoV-2 infection with virus-associated lung damage, decreased lung diffusion capacity (reduced DLco) and small airway dysfunction (increased AX and/or R5-R20) were noted in some patients. Impulse oscillometry should be included in the comprehensive functional assessment plan for patients after SARS-CoV-2 infection to diagnose small airway dysfunction.

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Dynamics of functional changes in the respiratory system after COVID-19-associated lung injury at one year after hospital discharge

Cited by 3 publications

References 30 publications

Breath assessment at with post-tuberculosis patients suffered new coronavirus infection

Breath assessment at with post-tuberculosis patients suffered new coronavirus infection

Surfactant protein D as a marker of persistent impairment of the lungs diffusion capacity in the long-term period in patients who had suffered from severe COVID-19

Long-term consequences of the functional state of the respiratory system after SARS-CoV-2-associated lung damage

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