Pulmonary function of patients with 2019 novel coronavirus induced pneumonia: A Retrospective Cohort Study

Abstract

Background: Pulmonary fibrosis is a common complication in patients with viral pneumonia, which causes restricted ventilation disorders and affects the prognosis of patients. However, the pulmonary function of patients with 2019 novel coronavirus (COVID-19)-induced pneumonia has not yet been reported.Methods: A retrospective analysis of 137 patients with COVID-19-induced pneumonia who were discharged from the Enze Hospital, Taizhou Enze Medical Center (Group), from January 31, 2020, to March 11, 2020. Follow-up occurred two weeks after hospital discharge, whereupon patients received a pulmonary function test. Results: Of the 137 patients who received a pulmonary function test two weeks after discharge, 51.8% were male, and the mean age was 47 years. Only 19.7% of the patients were identified as having severe novel coronavirus pneumonia. The pulmonary function test showed that for a small number of patients ((FEV1/FVC)/% <70%,) the mean ICV and FVC was 2.4±0.7 L, 3.2±0.8 L, respectively. In severe cases, 88.9% of patients had an IVC <80% of the predicted value and 55.6% of patients had an FVC <80% of the predicted value. The MEF25, MEF50, and MEF75 <70% values were 55.6%, 40.7%, and 25.9%, respectively. In the non-severe group, 79.1% of patients has an IVC <80% of the predicted value, and 16.4% of patients had an FVC <80% of the predicted value. The mean MEF25, MEF50, and MEF75 <70% values were 57.3%, 30%, and 13.6%, respectively.Conclusions: In this study, the results suggest that the pulmonary function of patients with 2019 novel coronavirus (COVID-19)-induced pneumonia manifested as restrictive ventilation disorder and small airway obstruction. The incidence was increased among critically ill patients.Trial registration number: ChiCTR2000029866.

COVID-19 and post-infectious myalgic encephalomyelitis/chronic fatigue syndrome: a narrative review

“…109 However, the dyspnea reported in post-COVID studies is not clearly described as a manifestation of orthostatic intolerance and may in fact represent fibrosis following inflammatory lung injury. 76–78 This theory would be supported by the presence of clinically detectable abnormalities on imaging and pulmonary function testing in post-acute COVID-19 patients. 73,74 Similar findings can be seen in survivors of acute respiratory distress syndrome, suggesting an organic cause for dyspnea.…”

“…However, it is important to note that multiple post-acute COVID-19 studies have found no association between illness severity, presence of chronic symptoms, and objective measures of respiratory function, suggesting an alternate mechanism of pathogenesis. 72,73,75,77,82…”

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

“…One study involved only elderly subjects, 14 whereas the other six involved subjects with a wide range of age groups. [15][16][17][18][19][20] Six studies reported the clinical status of subjects during hospitalization. Lung imaging results were available in four studies with lung abnormalities appearing in most subjects.…”

“…Two studies reported the lung function test data of individual subject, 15,20 and six studies reported the average mean values. [14][15][16][17][18][19] The timing of spirometry/LFT test were varied across studies, ranging from a day before discharge to more than a month after discharge.…”

Could routine race-adjustment of spirometers exacerbate racial disparities in COVID-19 recovery?

“…For example, restrictive ventilatory dysfunction is emerging as a problem in COVID-19 patients, evident for at least 2 weeks after hospital discharge. 7 This defect is indicated by a spirometry measure of forced vital capacity-the total amount of air that can be expelled from total lung capacity-below the lower limits of normal for the appropriate reference population. 8 Clinicians might miss this diagnosis if lower lung capacity measures are considered normal for minority populations.…”