Pietruszka-Wałęka Ewa, Rząd Michał, Żabicka Magdalena, Rożyńska Renata, Miklusz Piotr, Zieniuk-Lesiak Emilia, Jahnz-Różyk Karina
Department of Internal Medicine, Pneumonology, Allergology and Clinical Immunology, Military Institute of Medicine-National Research Institute, Szaserów 128, 04-141 Warsaw, Poland.
Department of Radiology, Military Institute of Medicine-National Research Institute, Szaserów 128, 04-141 Warsaw, Poland.
J Clin Med. 2023 Dec 21;13(1):45. doi: 10.3390/jcm13010045.
One of the most commonly observed complications after COVID-19 is persistent pulmonary impairment. The aim of this study was to evaluate the impact of individual factors during the acute phase of COVID-19 on subsequent pulmonary function test results. The study involved 46 patients who were admitted to hospital due to respiratory failure caused by SARS-CoV-2 and who were assessed during follow-up visits at 3 and 9 months after discharge. Patients were divided into two subgroups according to the severity of respiratory failure. The severe group included patients requiring mechanical ventilation or HFNOT. The results of the study showed that a severe course of the disease was associated with a lower FVC and a higher FEV1/FVC ratio 3 months after discharge (both < 0.05). In addition, it has been revealed that the length of hospitalization is a factor that negatively impacts the FEV1, FVC and TLC values measured at follow-up after 3 months. Furthermore, the obtained results identify the presence of cough in the acute phase of the disease as a factor having a positive impact on several PFT parameters (especially the FEV1/FVC ratio) as well as the 6MWT outcome after 3 months. The FVC improved significantly ( < 0.05) between the follow-up visits. The findings may indicate that COVID-19-induced respiratory dysfunction is usually temporary and spontaneously resolves during recovery. Recovery is slower in those who required more intensive oxygenation. The results of this study may be useful in identifying patients who require more intensive and longer rehabilitation after COVID-19.
新型冠状病毒肺炎（COVID-19）后最常见的并发症之一是持续性肺功能损害。本研究的目的是评估COVID-19急性期个体因素对后续肺功能测试结果的影响。该研究纳入了46例因严重急性呼吸综合征冠状病毒2（SARS-CoV-2）导致呼吸衰竭而入院的患者，并在出院后3个月和9个月的随访中对其进行评估。根据呼吸衰竭的严重程度将患者分为两个亚组。重症组包括需要机械通气或高流量鼻导管吸氧（HFNOT）的患者。研究结果显示，疾病的严重病程与出院后3个月时较低的用力肺活量（FVC）和较高的第一秒用力呼气容积/用力肺活量（FEV1/FVC）比值相关（均P<0.05）。此外，研究发现住院时间是对3个月后随访时测得的FEV1、FVC和肺总量（TLC）值有负面影响的一个因素。此外，研究结果表明，疾病急性期出现咳嗽是对多个肺功能测试参数（尤其是FEV1/FVC比值）以及3个月后6分钟步行试验（6MWT）结果有积极影响的一个因素。随访期间FVC有显著改善（P<0.05）。这些发现可能表明，COVID-19引起的呼吸功能障碍通常是暂时的，在恢复过程中会自发缓解。需要更强化氧疗的患者恢复较慢。本研究结果可能有助于识别COVID-19后需要更强化和更长时间康复治疗的患者。
