Cornelissen Merel E B, Leliveld Asabi, Baalbaki Nadia, Gach Debbie, van der Lee Ivo, Nossent Esther J, Bloemsma Lizan D, Maitland-van der Zee Anke H
Department of Pulmonary Medicine, Amsterdam UMC, University of Amsterdam, 1105, AZ Amsterdam, the Netherlands.
Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands.
Heliyon. 2024 Mar 13;10(6):e27964. doi: 10.1016/j.heliyon.2024.e27964. eCollection 2024 Mar 30.
To describe pulmonary function 3-6 months following acute COVID-19, to evaluate potential predictors of decreased pulmonary function and to review literature for the effect of COVID-19 on pulmonary function.
A systematic review and cohort study were conducted. Within the P4O2 COVID-19 cohort, 95 patients aged 40-65 years were recruited from outpatient post-COVID-19 clinics in five Dutch hospitals between May 2021-September 2022. At 3-6 months post COVID-19, medical records data and biological samples were collected and questionnaires were administered. In addition, pulmonary function tests (PFTs), including spirometry and transfer factor, were performed. To identify factors associated with PFTs, linear regression analyses were conducted, adjusted for covariates.
In PFTs (n = 90), mean ± SD % of predicted was 89.7 ± 18.2 for forced vital capacity (FVC) and 79.8 ± 20.0 for transfer factor for carbon monoxide (DLCO). FVC was <LLN in 24.4%, and DLCO was <LLN in 40.2% of patients. Univariable analyses showed that higher age, severe acute infection, pulmonary embolism during acute infection, and male sex were associated with lower DLCO. Multivariable analysis showed that age (adjusted difference [95%CI] = -0.07 [-0.13,-0.02] per one year increase) and severe acute infection (-0.80 [-1.54,-0.05]) were independently associated with a decreased DLCO. In literature we found days on oxygen supplementation, female sex, longer length of hospital stay, obesity and higher age to be associated with lower DLCO after COVID-19.
A low DLCO 3-6 months following acute COVID-19 was observed more often than a low FVC, both in the P4O2 COVID-19 study and the literature review.
描述急性新冠病毒病（COVID-19）后3至6个月的肺功能，评估肺功能下降的潜在预测因素，并综述有关COVID-19对肺功能影响的文献。
进行了一项系统评价和队列研究。在P4O2 COVID-19队列中，2021年5月至2022年9月期间，从荷兰五家医院的COVID-19门诊招募了95名年龄在40至65岁之间的患者。在COVID-19后3至6个月，收集病历数据和生物样本并发放问卷。此外，还进行了肺功能测试（PFT），包括肺活量测定和转移因子测定。为了确定与PFT相关的因素，进行了线性回归分析，并对协变量进行了调整。
在PFT（n = 90）中，用力肺活量（FVC）的预测值平均±标准差百分比为89.7±18.2，一氧化碳转移因子（DLCO）为79.8±20.0。24.4%的患者FVC低于正常下限（LLN），40.2%的患者DLCO低于LLN。单变量分析显示，年龄较大、严重急性感染、急性感染期间发生肺栓塞以及男性与较低的DLCO相关。多变量分析显示，年龄（每增加一岁调整差异[95%置信区间]=-0.07[-0.13，-0.02]）和严重急性感染（-0.80[-1.54，-0.05]）与DLCO降低独立相关。在文献中，我们发现吸氧天数、女性、住院时间较长、肥胖和年龄较大与COVID-19后较低的DLCO相关。
在P4O2 COVID-19研究和文献综述中，急性COVID-19后3至6个月出现低DLCO的情况比低FVC更为常见。
