Clínica de Enfermedades Respiratorias, Hospital Regional de Alta Especialidad de La Peninsula de Yucatan, Calle 7 #433 por 20 y 22. Fracc. Altabrisa, Mérida, Yucatan, Mexico.
Department of Physiology and Membrane Biology, University of California, Davis, USA.
BMC Pulm Med. 2022 Jul 31;22(1):294. doi: 10.1186/s12890-022-02086-9.
Few studies have assessed lung function in Hispanic subjects recovering from mild COVID-19. Therefore, we examined the prevalence of impaired pulmonary diffusing capacity for carbon monoxide (DLCO) as defined by values below the lower limit of normal (< LLN, < 5th percentile) or less than 80% of predicted in Hispanics recovering from mild COVID-19. We also examined the prevalence of a restrictive spirometric pattern as defined by the ratio of forced expiratory volume in 1 s (FEV) to forced vital capacity (FVC) being ≥ LLN with the FVC being < LLN. Finally, we evaluated previous studies to find factors correlated to impaired DLCO post-COVID-19.
In this observational study, adult patients (n = 146) with mild COVID-19 were recruited from a long-term follow-up COVID-19 clinic in Yucatan, Mexico, between March and August 2021. Spirometry, DLCO, and self-reported signs/symptoms were recorded 34 ± 4 days after diagnosis.
At post-evaluation, 20% and 30% of patients recovering from COVID-19 were classified as having a restrictive spirometric pattern and impaired DLCO, respectively; 13% had both. The most prevalent reported symptoms were fatigue (73%), a persistent cough (43%), shortness of breath (42%) and a blocked/runny nose (36%). Increased age and a restrictive spirometric pattern increased the probability of having an impaired DLCO while having a blocked nose and excessive sweating decreased the likelihood. The proportion of patients with previous mild COVID-19 and impaired DLCO increased by 13% when the definition of impaired DLCO was < 80% predicted instead of below the LLN. When comparing previous studies, having severe COVID-19 increased the proportion of those with impaired DLCO by 21% compared to those with mild COVID-19.
One-third of patients with mild COVID-19 have impaired DLCO thirty-four days post-diagnosis. The criteria that define impaired DLCO and the severity of COVID-19 disease affects the proportion of those with impaired DLCO at follow-up. One-fifth of patients have a restrictive spirometric pattern.
很少有研究评估从轻度 COVID-19 中康复的西班牙裔患者的肺功能。因此，我们检查了在从轻度 COVID-19 中康复的西班牙裔患者中，定义为低于正常值下限（<LLN，<第 5 百分位）或低于预测值 80%的肺一氧化碳弥散量（DLCO）受损的患病率。我们还检查了以第 1 秒用力呼气量（FEV）与用力肺活量（FVC）的比值大于等于 LLN 而 FVC 小于 LLN 的限制性肺量计模式的患病率，定义为受限模式。最后，我们评估了以前的研究，以找到与 COVID-19 后 DLCO 受损相关的因素。
在这项观察性研究中，从 2021 年 3 月至 8 月在墨西哥尤卡坦州的一个长期 COVID-19 诊所招募了 146 名患有轻度 COVID-19 的成年患者。在诊断后 34 ± 4 天记录肺量计、DLCO 和自我报告的体征/症状。
在评估后，20%和 30%的 COVID-19 康复患者分别被归类为存在限制性肺量计模式和 DLCO 受损，13%的患者同时存在两种情况。最常见的报告症状是疲劳（73%）、持续咳嗽（43%）、呼吸急促（42%）和鼻塞/流鼻涕（36%）。年龄增加和限制性肺量计模式增加了 DLCO 受损的可能性，而鼻塞和过度出汗则降低了可能性。当使用低于预测值 80%的 DLCO 而不是低于 LLN 来定义 DLCO 受损时，以前患有轻度 COVID-19 和 DLCO 受损的患者比例增加了 13%。当比较以前的研究时，与患有轻度 COVID-19 的患者相比，患有严重 COVID-19 的患者 DLCO 受损的比例增加了 21%。
三分之一的轻度 COVID-19 患者在诊断后 34 天 DLCO 受损。定义 DLCO 受损的标准和 COVID-19 疾病的严重程度会影响随访时 DLCO 受损患者的比例。五分之一的患者存在限制性肺量计模式。
