University of Kragujevac, Serbia, Faculty of Medical Sciences, Department of Internal medicine, Serbia; Clinic for Pulmonology, University Clinical Centre "Kragujevac" Kragujevac, Serbia.
University of Kragujevac, Serbia, Faculty of Medical Sciences, Department of Internal medicine, Serbia; Clinical for Cardiology, University Clinical Centre "Kragujevac" Kragujevac, Serbia.
Respir Med Res. 2023 Jun;83:100947. doi: 10.1016/j.resmer.2022.100947. Epub 2023 Feb 21.
To perform pulmonary function tests (PFT) in severe COVID-19 survivors one and five months after hospital discharge in order to assess the lung function, as well to identify clinical characteristics and PFT parameters associated with worse cardiopulmonary exercise testing (CPET).
A prospective study included 75 patients with severe form of COVID-19. PFT was conducted one and five months after hospital discharge, in addition to CPET in a second assessment. Patients with a previous history of chronic respiratory diseases were excluded from our study.
One month after hospital discharge, all examined patients had diffusion lung capacity for carbon-monoxide(DLco%) below the 80% of predicted values (in mean 58%), with 40% of patients having a restrictive pattern (total lung capacity(TLC) < 80%). In a repeated assessment after five months, pathological DLco% persisted in 40% of patients, while all other PFT parameters were normal. CPET showed reduced maximum oxygen consumption during exercise testing (VO2peak%) values in 80% of patients (in mean 69%), and exercise ventilatory inefficiency in 60%. Patients with VO2peak < 60% had significantly lower values of examined PFT parameters, both one and five months after hospital discharge. Patients with VO2peak% ≥ 60% had a significantly higher increase after the second assessment for Forced expiratory volume in 1st second (FEV1%), Forced expiratory volume in 1st second and forced vital capacity ratio (FEV1/FVC), DLco% and Diffusion lung capacity for carbon monoxide corrected for alveolar volume (DLco/VA).
Significant functional abnormalities, according to PFT and CPET, was present both one and five months in severe COVID-19 survivors, thus emphasizing the importance of a comprehensive follow-up including both resting and dynamic functional assessment in these patients.
在严重 COVID-19 幸存者出院后 1 个月和 5 个月进行肺功能测试（PFT），以评估肺功能，并确定与心肺运动测试（CPET）结果更差相关的临床特征和 PFT 参数。
一项前瞻性研究纳入了 75 例严重 COVID-19 患者。在出院后 1 个月和 5 个月进行 PFT，在第二次评估时进行 CPET。我们的研究排除了有慢性呼吸系统疾病既往史的患者。
出院后 1 个月，所有接受检查的患者的一氧化碳弥散量（DLco%）均低于预计值的 80%（平均为 58%），40%的患者存在限制性模式（总肺容量（TLC）<80%）。在 5 个月后的重复评估中，40%的患者持续存在病理性 DLco%，而其他所有 PFT 参数均正常。CPET 显示 80%的患者运动试验时最大摄氧量（VO2peak%）值降低（平均为 69%），且运动通气效率低下的占 60%。VO2peak<60%的患者出院后 1 个月和 5 个月时，所检查的 PFT 参数值明显较低。VO2peak%≥60%的患者在第二次评估时，用力肺活量第一秒（FEV1%）、第一秒用力肺活量与用力肺活量比值（FEV1/FVC）、DLco%和一氧化碳弥散量与肺泡容积比（DLco/VA）的增加明显更高。
严重 COVID-19 幸存者出院后 1 个月和 5 个月时，PFT 和 CPET 均显示出明显的功能异常，这强调了对这些患者进行综合随访的重要性，包括静息和动态功能评估。
