LHL Hospital Gardermoen, Jessheim, Norway.
Dept of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.
Eur Respir J. 2021 Aug 26;58(2). doi: 10.1183/13993003.00996-2021. Print 2021 Aug.
This study aimed to describe cardiopulmonary function during exercise 3 months after hospital discharge for COVID-19 and compare groups according to dyspnoea and intensive care unit (ICU) stay.
Participants with COVID-19 discharged from five large Norwegian hospitals were consecutively invited to a multicentre, prospective cohort study. In total, 156 participants (mean age 56.2 years, 60 females) were examined with a cardiopulmonary exercise test (CPET) 3 months after discharge and compared with a reference population. Dyspnoea was assessed using the modified Medical Research Council (mMRC) dyspnoea scale.
Peak oxygen uptake (' ) <80% predicted was observed in 31% (n=49). Ventilatory efficiency was reduced in 15% (n=24), while breathing reserve <15% was observed in 16% (n=25). Oxygen pulse <80% predicted was found in 18% (n=28). Dyspnoea (mMRC ≥1) was reported by 47% (n=59). These participants had similar ' (p=0.10) but lower mean±sd ' ·kg % predicted compared with participants without dyspnoea (mMRC 0) (76±16% 89±18%; p=0.009) due to higher body mass index (p=0.03). For ICU- non-ICU-treated participants, mean±sd ' % predicted was 82±15% and 90±17% (p=0.004), respectively. Ventilation, breathing reserve and ventilatory efficiency were similar between the ICU and non-ICU groups.
One-third of participants experienced ' <80% predicted 3 months after hospital discharge for COVID-19. Dyspnoeic participants were characterised by lower exercise capacity due to obesity and lower ventilatory efficiency. Ventilation and ventilatory efficiency were similar between ICU- and non-ICU-treated participants.
本研究旨在描述 COVID-19 出院后 3 个月时的心肺功能,并根据呼吸困难和重症监护病房(ICU)入住情况对各组进行比较。
从挪威五家大型医院出院的 COVID-19 患者连续受邀参加一项多中心前瞻性队列研究。共有 156 名患者(平均年龄 56.2 岁,60 名女性)在出院后 3 个月接受心肺运动试验(CPET)检查,并与参考人群进行比较。呼吸困难采用改良的医学研究委员会(mMRC)呼吸困难量表进行评估。
31%(n=49)的患者峰值摄氧量(' )<80%预计值。15%(n=24)的患者通气效率降低,16%(n=25)的患者呼吸储备<15%。18%(n=28)的患者氧脉搏<80%预计值。47%(n=59)的患者报告有呼吸困难(mMRC≥1)。这些患者的' (p=0.10)相似,但与无呼吸困难(mMRC 0)的患者相比,平均±标准差'·kg %预计值较低(76±16% 89±18%;p=0.009),原因是体重指数较高(p=0.03)。对于 ICU-非 ICU 治疗的患者,平均±标准差' %预计值分别为 82±15%和 90±17%(p=0.004)。通气、呼吸储备和通气效率在 ICU 组和非 ICU 组之间相似。
COVID-19 出院后 3 个月,三分之一的患者出现' <80%预计值。呼吸困难的患者由于肥胖和较低的通气效率,运动能力较低。ICU 治疗和非 ICU 治疗的患者通气和通气效率相似。