Núñez-Fernández Marta, Ramos-Hernández Cristina, García-Río Francisco, Torres-Durán María, Nodar-Germiñas Andrés, Tilve-Gómez Amara, Rodríguez-Fernández Paula, Valverde-Pérez Diana, Ruano-Raviña Alberto, Fernández-Villar Alberto
Service of Pneumology, University Hospital Complex of Vigo, NeumoVigo I+i. Institute of Health Research South Galicia (IISGS), 36213 Vigo, Spain.
Service of Pneumology La Paz-IdiPAZ University Hospital, 28046 Madrid, Spain.
J Clin Med. 2021 May 14;10(10):2119. doi: 10.3390/jcm10102119.
Three to four months after hospitalisation for COVID-19 pneumonia, the most frequently described alteration in respiratory function tests (RFTs) is decreased carbon monoxide transfer capacity (DL).
This is a prospective cohort study that included patients hospitalised because of SARS-CoV-2 pneumonia, three months after their discharge. A clinical evaluation, analytical parameters, chest X-ray, six-minute walk test, spirometry and DL-DL analysis were performed. Demographic variables, comorbidities, and variables related to the severity of the admission were recorded.
Two hundred patients completed the study; 59.5% men, age 62 years, 15.5% admitted to the intensive care unit. The most frequent functional alteration, in 27% of patients, was in the DL-DL combination. This alteration was associated with age, male sex, degree of dyspnoea, poorer perception of health, and limited ability for physical effort. These patients also presented higher levels of D-Dimer and more residual radiological alterations. In 42% of the patients with diffusion alterations, only reduced DL was presented, along with lower D-Dimer levels and less capillary volume involvement. The severity of the process was associated with the reduction in DL-DL.
The most sensitive RFT for the detection of the sequelae of COVID-19 pneumonia was the combined measurement of DL-DL and this factor was related to patient health status and their capacity for physical exertion. In 40% of these cases, there was only a reduction in DL, a finding that may indicate less pulmonary vascular involvement.
新型冠状病毒肺炎住院三到四个月后，呼吸功能测试（RFT）中最常描述的改变是一氧化碳转运能力（DL）下降。
这是一项前瞻性队列研究，纳入因严重急性呼吸综合征冠状病毒2肺炎住院的患者，在出院三个月后进行。进行了临床评估、分析参数、胸部X光、六分钟步行试验、肺量测定和DL-DL分析。记录了人口统计学变量、合并症以及与入院严重程度相关的变量。
200名患者完成了研究；男性占59.5%，年龄62岁，15.5%入住重症监护病房。27%的患者中最常见的功能改变是DL-DL组合异常。这种改变与年龄、男性性别、呼吸困难程度、健康感知较差以及体力活动能力受限有关。这些患者还表现出更高水平的D-二聚体和更多的残留放射学改变。在42%的有弥散异常的患者中，仅表现为DL降低，同时D-二聚体水平较低且毛细血管容积受累较少。疾病的严重程度与DL-DL的降低有关。
检测新型冠状病毒肺炎后遗症最敏感的呼吸功能测试是DL-DL的联合测量，且该因素与患者健康状况及其体力活动能力有关。在40%的这些病例中，仅DL降低，这一发现可能表明肺血管受累较少。
