Functional changes in the respiratory system after COVID-19-associated lung injury

The problem of long COVID-19 (COronaVIrus Disease 2019) has been highly relevant for the healthcare system in the last three years. The persistence of respiratory symptoms, radiological and functional changes in COVID-19 patients brings new challenges to the entire medical community. The aim of the study is to explore long-term clinical and functional changes in patients with severe COVID-19-associated lung injury, including assessment of functional and radiological abnormalities of the respiratory system, as well as persistent clinical symptoms a year after the acute phase of the disease. Methods. The study included 45 patients who were examined 3, 6 and 12 months after COVID-19 with severe lung damage (more than 50% according to chest CT in the acute phase of the disease). Patients underwent multispiral computed tomography of the chest organs, a comprehensive study of respiratory function (spirography, body plethysmography and diffusion test); the clinical symptoms were assessed. Results. Chest CT scans showed gradual regression of pathological changes during the follow-up. However, radiographic changes of varying severity persisted after 12 months of follow-up in 51% of patients. A year later, restrictive disorders persisted in 20% of patients and the diffusion capacity of the lungs was reduced in 69% of patients. At the same time, a statistically significant difference in the DLСО level was observed between 3, 6 and 12 months. The severity of dyspnea decreased 1 year after hospitalization in 48% of patients. Conclusion. The obtained results demonstrate a gradual regression of both radiological and functional pathological changes during the 1st year. However, CT changes and deviations of the respiratory function persist in some patients, mainly in the form of a decrease in DLСО, which necessitates further monitoring of this group of patients.

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Assessment of long-term clinical and functional changes in patients recovering from severe COVID-19-associated lung damage

Abdullaeva

Avdeev

Fominykh

et al. 2023

Pulʹmonologiâ (Mosk.)

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

Chernyak,

Mustafina,

Naumenko

et al. 2023

Pulʹmonologiâ (Mosk.)

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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 (38 men/22 women, aged 39 to 80 years) with a diagnosis of “COVID-19-associated interstitial process in the lungs” were examined. Lung function (spirometry, body plethysmography, and lung diffusion capacity testing) was examined in all patients twice, at 1 – 6 months (visit 1) and at 12 – 24 months (visit 2) after hospital discharge. Results. At visit 1, 60% of patients had restrictive pulmonary ventilation disorders. Obstructive ventilation disorders were detected in only 1 patient. Decreased lung diffusion capacity (D CO corr.) was found in 78% of patients. At visit 2, obstructive disorders were detected in 1 patient, and the frequency of restrictive ventilation disorders was 29%. Decreased DLCO corr. was noted in 57% of cases. The parameters of pulmonary ventilation and pulmonary gas exchange function differed significantly between visits. Significant correlations were found between changes in the functional parameters of the respiratory system and disorders identified at visit 1 after hospital discharge. Conclusion. Thus, there is a decrease in the lung diffusion capacity and the rate of restrictive ventilation disorders even one year after severe COVID-19-associated lung injury. However, our results suggest a marked improvement in respiratory system function over time.

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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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Functional changes in the respiratory system after COVID-19-associated lung injury

Cited by 5 publications

References 27 publications

Assessment of long-term clinical and functional changes in patients recovering from severe COVID-19-associated lung damage

Assessment of long-term clinical and functional changes in patients recovering from severe COVID-19-associated lung damage

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

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

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