Suppini Noemi, Fira-Mladinescu Ovidiu, Traila Daniel, Motofelea Alexandru Catalin, Marc Monica Steluta, Manolescu Diana, Vastag Emanuela, Maganti Ram Kiran, Oancea Cristian
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.
J Pers Med. 2023 Jul 26;13(8):1190. doi: 10.3390/jpm13081190.
Persistent pulmonary impairment post-COVID-19 has been reported, albeit variably. This single-center observational study aims to longitudinally evaluate pulmonary function in 140 COVID-19 survivors one year after recovery, assessing associations with disease severity and pre-existing lung conditions. Participants aged 18 and older, with confirmed SARS-CoV-2 infection, were evaluated using spirometry and Diffusion Capacity of Lungs for Carbon Monoxide (DLCO) tests. Pulmonary function parameters like Forced Expiratory Volume at 1 s (FEV1), Forced Vital Capacity (FVC), and Total Lung Capacity (TLC) were measured. Participants were stratified by age, gender, body mass index, smoking status, and lung damage severity via computed tomography (CT). The cohort consisted of mostly males (58.6%), with a mean age of 53.8 years and body mass index of 24.9 kg/m. Post-COVID fibrosis was seen in 22.7%, 27.3%, and 51.9% of mild, moderate, and severe disease patients, respectively ( = 0.003). FVC significantly reduced with disease severity ( < 0.001), while FEV1, FEF25-75, and DLCO showed a non-significant downward trend. FEV1/FVC ratio increased with disease severity ( = 0.033), and TLC and RV significantly declined ( = 0.023 and = 0.003, respectively). A one-year follow-up indicated a non-significant change in FVC, FEV1, FEV1/FVC ratio, FEF25-75, and RV compared with the 40-day measurement, but it revealed significant improvements in DLCO and TLC ( = 0.010). There were significant mean increases in FVC, FEV1, DLCO, TLC, and RV across all disease severities over one year. They were most pronounced in the patients with a history of severe COVID-19, who had a better recovery over one year, compared with the mild and moderate COVID-19 patients whose lung function almost normalized. One year after the SARS-CoV-2 infection, we observed a significant association between disease severity and post-COVID fibrotic changes. Though some lung function parameters remained stable over the year, significant improvements were noted in DLCO and TLC. Particularly, individuals with severe disease showed substantial recovery in lung function, indicating the potential reversibility of COVID-19-related pulmonary damage.
已有报告称，新冠病毒感染康复后会持续存在肺功能损害，不过情况各不相同。这项单中心观察性研究旨在对140名新冠病毒感染康复者康复一年后的肺功能进行纵向评估，评估其与疾病严重程度和既往肺部疾病的关联。对年龄在18岁及以上、确诊感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的参与者进行了肺活量测定和肺一氧化碳弥散量（DLCO）测试评估。测量了诸如第1秒用力呼气量（FEV1）、用力肺活量（FVC）和肺总量（TLC）等肺功能参数。通过计算机断层扫描（CT），根据年龄、性别、体重指数、吸烟状况和肺损伤严重程度对参与者进行分层。该队列主要由男性（58.6%）组成，平均年龄为53.8岁，体重指数为24.9kg/m²。轻度、中度和重度疾病患者中，新冠后纤维化的发生率分别为22.7%、27.3%和51.9%（P = 0.003）。FVC随疾病严重程度显著降低（P < 0.001），而FEV1、FEF25 - 75和DLCO呈非显著下降趋势。FEV1/FVC比值随疾病严重程度增加（P = 0.033），TLC和残气量（RV）显著下降（分别为P = 0.023和P = 0.003）。一年的随访表明，与40天测量结果相比，FVC、FEV1、FEV1/FVC比值、FEF25 - 75和RV无显著变化，但DLCO和TLC有显著改善（P = 0.010）。在所有疾病严重程度组中，FVC、FEV1、DLCO、TLC和RV在一年中均有显著的平均增加。在有重症新冠病毒感染病史的患者中最为明显，与肺功能几乎恢复正常的轻度和中度新冠病毒感染患者相比，他们在一年中有更好的恢复。在感染SARS-CoV-2一年后，我们观察到疾病严重程度与新冠后纤维化改变之间存在显著关联。尽管一些肺功能参数在这一年中保持稳定，但DLCO和TLC有显著改善。特别是，重症患者的肺功能有显著恢复，表明新冠病毒相关肺损伤具有潜在的可逆性。
