Respiratory Outcomes in Patients Following COVID-19-Related Hospitalization: A Meta-Analysis

Guo, Tao; Jiang, Fangfang; Liu, Yuanyuan; Zhao, Yunpeng; Li, Yiran; Wang, Yihua

doi:10.3389/fmolb.2021.750558

Cited by 12 publications

(12 citation statements)

References 27 publications

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“…The combined evidence indicates that impairments in DLCO are more prevalent than restrictive lung disease in patients. This is supported by two metaanalyses in patients post-COVID-19 [28,48], which showed that 6 months after discharge, 43% of patients still had a DLCO < 80% of predicted [48]. Considering this great fraction of patients with markedly low DLCO, impaired lung diffusion capacity may contribute to low VO 2peak in some patients [49].…”

Section: Pulmonary System (Gear 1)mentioning

confidence: 84%

Low Cardiorespiratory Fitness Post-COVID-19: A Narrative Review

et al. 2022

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Patients recovering from COVID-19 often report symptoms of exhaustion, fatigue and dyspnoea and present with exercise intolerance persisting for months post-infection. Numerous studies investigated these sequelae and their possible underlying mechanisms using cardiopulmonary exercise testing. We aimed to provide an in-depth discussion as well as an overview of the contribution of selected organ systems to exercise intolerance based on the Wasserman gears. The gears represent the pulmonary system, cardiovascular system, and periphery/musculature and mitochondria. Thirty-two studies that examined adult patients post-COVID-19 via cardiopulmonary exercise testing were included. In 22 of 26 studies reporting cardiorespiratory fitness (herein defined as peak oxygen uptake— V O 2peak ), V O 2peak was < 90% of predicted value in patients. V O 2peak was notably below normal even in the long-term. Given the available evidence, the contribution of respiratory function to low V O 2peak seems to be only minor except for lung diffusion capacity. The prevalence of low lung diffusion capacity was high in the included studies. The cardiovascular system might contribute to low V O 2peak via subnormal cardiac output due to chronotropic incompetence and reduced stroke volume, especially in the first months post-infection. Chronotropic incompetence was similarly present in the moderate- and long-term follow-up. However, contrary findings exist. Peripheral factors such as muscle mass, strength and perfusion, mitochondrial function, or arteriovenous oxygen difference may also contribute to low V O 2peak . More data are required, however. The findings of this review do not support deconditioning as the primary mechanism of low V O 2peak post-COVID-19. Post-COVID-19 sequelae are multifaceted and require individual diagnosis and treatment. Supplementary Information The online version contains supplementary material available at 10.1007/s40279-022-01751-7.

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Section: Pulmonary System (Gear 1)mentioning

confidence: 84%

Low Cardiorespiratory Fitness Post-COVID-19: A Narrative Review

et al. 2022

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“…The development of respiratory sequelae in patients surviving pneumonic processes caused by the SARS-CoV-2 has been a matter of particular concern and interest since the beginning of the pandemic [1,2]. Numerous studies analyzing the short-and mid-term (first 6 months) persistence of clinical, radiological, and functional alterations have been published to date, with remarkable differences in their results (presence in 20-80% of the patients under study) depending on the patient populations included, the pneumonia severity, the type of supportive treatment administered and the methodology used [3][4][5][6]. The main clinical sequelae are persistent dyspnea, limitations on physical effort and general health status alterations.…”

Section: Introductionmentioning

confidence: 99%

“…At a radiological level, the most frequently reported sequelae are the presence of areas of ground-glass opacity and either reticular lesions or parenchymal bands. With respect to the lung function, the most common findings are alterations in the diffusing capacity for carbon monoxide (DL CO ) and a decrease in total lung capacity [3][4][5][6][7][8][9][10][11]. However, to date there is only scare and heterogeneous evidence available on the longer-term sequelae (≥ 1 year from hospitalization) [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

“…With respect to the lung function, the most common findings are alterations in the diffusing capacity for carbon monoxide (DL CO ) and a decrease in total lung capacity [3][4][5][6][7][8][9][10][11]. However, to date there is only scare and heterogeneous evidence available on the longer-term sequelae (≥ 1 year from hospitalization) [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. Concerning the DL CO decrease, there is considerable debate, owing to the reference values used, the interpretation of the carbon monoxide transfer coefficient (K CO ) and the alveolar volume (VA), or the use of the reference percentage (%) instead of the lower limit of normality (LLN) [7,8,19,20].…”

Section: Introductionmentioning

confidence: 99%

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Evolution and long‑term respiratory sequelae after severe COVID-19 pneumonia: nitric oxide diffusion measurement value

et al. 2023

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Introduction There are no published studies assessing the evolution of combined determination of the lung diffusing capacity for both nitric oxide and carbon monoxide (DLNO and DLCO) 12 months after the discharge of patients with COVID-19 pneumonia. Methods Prospective cohort study which included patients who were assessed both 3 and 12 months after an episode of SARS-CoV-2 pneumonia. Their clinical status, health condition, lung function testings (LFTs) results (spirometry, DLNO-DLCO analysis, and six-minute walk test), and chest X-ray/computed tomography scan images were compared. Results 194 patients, age 62 years (P25–75, 51.5–71), 59% men, completed the study. 17% required admission to the intensive care unit. An improvement in the patients’ exercise tolerance, the extent of the areas of ground-glass opacity, and the LFTs between 3 and 12 months following their hospital discharge were found, but without a decrease in their degree of dyspnea or their self-perceived health condition. DLNO was the most significantly altered parameter at 12 months (19.3%). The improvement in DLNO-DLCO mainly occurred at the expense of the recovery of alveolar units and their vascular component, with the membrane factor only improving in patients with more severe infections. Conclusions The combined measurement of DLNO-DLCO is the most sensitive LFT for the detection of the long-term sequelae of COVID-19 pneumonia and it explain better their pathophysiology.

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“…Studies have varied widely with respect to population size, time to follow up, and COVID-19 severity, however, the majority have demonstrated lung function abnormalities with prevalence ranging from 25-50% [ [2] , [3] , [4] , [5] ]. The most consistently documented and long-lasting abnormalities have been decreases in diffusion capacity of carbon dioxide (DLCO) and total lung capacity (TLC) [ 2 , 3 , [6] , [7] , [8] ].…”

Section: Introductionmentioning

confidence: 99%