Respiratory function in patients post-infection by COVID-19: a systematic review and meta-analysis

Torres‐Castro, Rodrigo; Vasconcello‐Castillo, Luis; Alsina-Restoy, Xavier; Solís‐Navarro, Lilian; Burgos, Felip; Puppo, Homero; Vilaró, Jordi

doi:10.1016/j.pulmoe.2020.10.013

Cited by 388 publications

(422 citation statements)

References 24 publications

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“…Since the SARS-CoV-2 outbreak, there has been increasing concern about the potential risk of parenchymal fibrosis and lung function impairment. The most important factor is lung diffusion capacity [ 17 ]. Zhao et al [ 6 ] reported that three months after COVID-19 discharge, a high percentage of CT abnormalities (70.9%) and DLCO anomalies (16.4%) were still present in recovering patients.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary long-term consequences of COVID-19 infections after hospital discharge

Blanco

Cobos-Ceballos

Navarro

et al. 2021

Clinical Microbiology and Infection

114

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Objectives COVID-19 survivors are reporting residual abnormalities after discharge from the hospital. Limited information is available about this stage of recovery or the lingering effects of the virus on pulmonary function and inflammation. The aim of this study was to describe lung function and to identify biomarkers in serum and induced sputum samples from patients recovering from COVID-19 hospitalisation. Methods Patients admitted to Spanish hospitals with laboratory-confirmed COVID-19 infection by a real-time PCR (RT-PCR) assay for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were recruited for this study. Each hospital screened their lists of discharged patients at least 45 days after symptom onset. SARS-CoV-2-infected patients were divided into mild/moderate and severe disease groups according to the severity of their symptoms during hospitalisation. Patients’ epidemiological and medical histories, comorbidities, chronic treatments, and laboratory parameters were evaluated. Pulmonary function tests, the standardised 6-minute walk test (6 MWT) and chest computed tomography (CT) were also performed. The levels of proteases, their inhibitors, and shed receptors were measured in serum and induced sputum samples. Results A total of 100 patients with respiratory function tests were included in this study. The median number of days after the onset of symptoms was 104 (IQR 89.25, 126.75). COVID-19 was severe in 47% (47/100) of patients. CT was normal in 48% (48/100) of patients. Lung function was normal (FEV1 ≥80%, FVC ≥80%, FEV1/FVC ≥0.7, and diffusing capacity for carbon monoxide [DLCO] ≥80%) in 92% (92/100), 94% (94/100), 100% (100/100) and 48% (48/100) of patients, respectively. Multivariate analysis showed that a DLCO <80% (OR 5.92; 95%CI 2.28-15.37; p <0.0001) and a lower serum LDH level (OR 0.98; 95%CI 0.97-0.99) were associated with the severe disease group of SARS-CoV-2 during hospital stay. Conclusions A diffusion deficit (DLCO <80%) was still present after hospital discharge and was associated with the most severe SARS-CoV-2 cases.

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Section: Discussionmentioning

confidence: 99%

Pulmonary long-term consequences of COVID-19 infections after hospital discharge

Blanco

Cobos-Ceballos

Navarro

et al. 2021

Clinical Microbiology and Infection

114

View full text Add to dashboard Cite

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“… 13 The sequelae after discharge and their impact on quality of life of the patient are not yet fully known. Some authors have reported lung damage in severe COVID-19 cases, such as fibrotic remodelling of the lung parenchyma 14 , 15 with pulmonary function impairment, 16 along with the persistence of symptoms for weeks to months after discharge. 17 The symptoms, like fatigue or dyspnoea, are patients reported outcomes and play an essential role in increasing patient engagement, improving health systems, and ensuring that clinical care and research is person-centred.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of potential respiratory symptoms in survivors of hospital admission after coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis

et al. 2021

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Knowledge on the sequelae of Coronavirus Disease 2019 (COVID-19) remains limited due to the relatively recent onset of this pathology. However, the literature on other types of coronavirus infections prior to COVID-19 reports that patients may experience persistent symptoms after discharge. To determine the prevalence of respiratory symptoms in survivors of hospital admission after COVID-19 infection. A living systematic review of five databases was performed in order to identify studies which reported the persistence of respiratory symptoms in COVID-19 patients after discharge. Two independent researchers reviewed and analysed the available literature, and then extracted and assessed the quality of those articles. Of the 1,154 reports returned by the initial search nine articles were found, in which 1,816 patients were included in the data synthesis. In the pooled analysis, we found a prevalence of 0.52 (CI 0.38–0.66, p < 0.01, I 2 = 97%), 0.37 (CI 0.28–0.48, p < 0.01, I 2 = 93%), 0.16 (CI 0.10–0.23, p < 0.01, I 2 = 90%) and 0.14 (CI 0.06–0.24, p < 0.01, I 2 = 96%) for fatigue, dyspnoea, chest pain, and cough, respectively. Fatigue, dyspnoea, chest pain, and cough were the most prevalent respiratory symptoms found in 52%, 37%, 16% and 14% of patients between 3 weeks and 3 months, after discharge in survivors of hospital admission by COVID-19, respectively.

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“… 2 It is estimated that up to 20% of patients develop severe respiratory illness, 3 and some cases must be admitted to intensive care units. 4 Together with the pulmonary impairments related to disease, 5 prolonged hospital stays can seriously affect the physical condition of patients due to the negative effects of bed rest and immobility. 6 …”

Section: Introductionmentioning

confidence: 99%

Use of sit-to-stand test to assess the physical capacity and exertional desaturation in patients post COVID-19

et al. 2021

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We propose the use of the 1-minute sit-to-stand test (1STST) to evaluate the physical capacity and exertional desaturation one month after discharge in a sample of patients who survived COVID-19 pneumonia. This was a cross-sectional study that collected routine data from consecutive patients admitted to the outpatient program in a public hospital in Chile. Patients were asked to complete a 1STST. Data were analyzed according to those with and without a prolonged hospital stay of >10 days. Eighty-three percent of the patients were able to complete the test (N = 50). The median age was 62.7 ± 12.5 years. The average number of repetitions in the 1STST was 20.9 ± 4.8. Thirty-two percent of patients had a decrease in pulse oxygen saturation (SpO2) ≥ 4 points. The prolonged hospital stay subgroup had a significant increase in exertional desaturation (mean difference = 2.6; 95% CI = 1.2 to 3.9; p = 0.001) and dyspnea (mean difference = 1.1; 95% CI = 0.4 to 2.1; p = 0.042) compared to the group of length of stay ≤10 days. In-hospital survivors of COVID-19, the 1STST showed a decrease in physical capacity at one month in those 90% who were able to complete it. The 1STST was able to discriminate between those with and without a prolonged hospital stay and was able to detect exertional desaturation in some patients.

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Respiratory function in patients post-infection by COVID-19: a systematic review and meta-analysis

Cited by 388 publications

References 24 publications

Pulmonary long-term consequences of COVID-19 infections after hospital discharge

Pulmonary long-term consequences of COVID-19 infections after hospital discharge

Prevalence of potential respiratory symptoms in survivors of hospital admission after coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis

Use of sit-to-stand test to assess the physical capacity and exertional desaturation in patients post COVID-19

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