Suppini Noemi, Oancea Cristian, Fira-Mladinescu Ovidiu, Traila Daniel, Pescaru Camelia, Marc Monica Steluta, Manolescu Diana, Vastag Emanuela, Ali Ayesha, Hogea Elena, Pilut Ciprian Nicolae
Discipline of Pulmonology, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania.
Center for Research and Innovation in Precision Medicine of Respiratory Diseases (CRIPMRD), "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania.
Diseases. 2023 Aug 5;11(3):102. doi: 10.3390/diseases11030102.
The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has had significant impacts on pulmonary function. This study aimed to comprehensively evaluate pulmonary function and structure in patients 40 days post-SARS-CoV-2 infection, employing an array of testing methodologies including spirometry, plethysmography, forced oscillometry, and CT scanning. It also sought to establish potential correlations between these metrics and evaluate if forced oscillometry could provide additional value in post-infective lung function assessment. A 40-day post-infection follow-up observational study was conducted involving 66 patients with confirmed SARS-CoV-2 infection. The results revealed decreases in FVC and FEF25-75 with the increasing severity of COVID-19. Specifically, patients with severe symptoms exhibited statistically significant decreases in FVC (mean = 86.8) compared with those with mild symptoms (mean = 106.0; = 0.018). The FEF25-75 showed a similar trend, with severe patients exhibiting a mean of 77.7 compared with 82.9 in the mild group ( = 0.017). Furthermore, resonant frequency (RF) increased with disease severity, with the severe group exhibiting a statistically significant increase (mean = 17.4) compared with the mild group (mean = 14.3; = 0.042). CT scans showed an increase in ground-glass opacities with disease severity, with 81.8% of severe patients demonstrating this finding ( = 0.037). Multiple regression analysis revealed that Reactance at 4 Hz (X4), Forced Expiratory Flow 25-75% (FEF25-75), and Resonant Frequency (RF) were significantly related to COVID-19 severity. Specifically, for each unit increase in these factors, the risk of the event was estimated to increase by a factor of 3.16, 2.09, and 1.90, respectively. Conversely, Resistance at 4 Hz (R4) and Airway Resistance (RAW) were found to significantly decrease the event hazard, highlighting their potential protective role. Spirometry, plethysmography, and forced oscillometry are effective in assessing these changes. Forced oscillometry may be particularly beneficial in identifying subtle changes in lung function post-COVID-19. Further studies are warranted to validate these findings and develop strategies to manage post-infective pulmonary changes in SARS-CoV-2 patients.
由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)病毒引起的2019冠状病毒病(COVID-19)大流行对肺功能产生了重大影响。本研究旨在全面评估SARS-CoV-2感染后40天患者的肺功能和结构,采用了一系列检测方法,包括肺活量测定法、体积描记法、强迫振荡法和CT扫描。该研究还试图建立这些指标之间的潜在相关性,并评估强迫振荡法在感染后肺功能评估中是否能提供额外价值。开展了一项感染后40天的随访观察性研究,纳入了66例确诊SARS-CoV-2感染的患者。结果显示,随着COVID-19严重程度的增加,用力肺活量(FVC)和25%-75%用力呼气流量(FEF25-75)降低。具体而言,与症状较轻的患者(平均值 = 106.0)相比,症状严重的患者FVC出现了具有统计学意义的下降(平均值 = 86.8;P = 0.018)。FEF25-75呈现出类似趋势,重症患者的平均值为77.7,而轻症组为82.9(P = 0.017)。此外,共振频率(RF)随疾病严重程度增加,重症组与轻症组相比出现了具有统计学意义的升高(平均值 = 17.4,而轻症组平均值 = 14.3;P = 0.042)。CT扫描显示,磨玻璃影随疾病严重程度增加,81.8%的重症患者出现此表现(P = 0.037)。多元回归分析显示,4赫兹时的电抗(X4)、25%-75%用力呼气流量(FEF25-75)和共振频率(RF)与COVID-19严重程度显著相关。具体而言,这些因素每增加一个单位,事件风险估计分别增加3.16倍、2.09倍和1.90倍。相反,发现4赫兹时的阻力(R4)和气道阻力(RAW)显著降低事件风险,突出了它们的潜在保护作用。肺活量测定法、体积描记法和强迫振荡法在评估这些变化方面是有效的。强迫振荡法在识别COVID-19后肺功能的细微变化方面可能特别有益。有必要进一步开展研究以验证这些发现,并制定策略来管理SARS-CoV-2患者感染后的肺部变化。