Department of Gastroenterology, Hepatology, Infectious Diseases and Endocrinology, Hannover Medical School, Hannover, Germany.
Institute of Virology, Hannover Medical School, Hannover, Germany.
Respiration. 2024;103(10):622-629. doi: 10.1159/000540297. Epub 2024 Jul 18.
SARS-CoV-2 infections can result in a broad spectrum of symptoms from mild to life-threatening. Long-term consequences on lung function are not well understood yet.
In our study, we have examined 134 post-COVID patients (aged 54.83 ± 14.4 years) with dyspnea on exertion as a leading symptom 6 weeks to 24 months after a SARS-CoV-2 infection for bronchodilator responsiveness during their stay in our pulmonary rehabilitation clinic.
Prior to bronchial dilation, 6 out of 134 patients (4.47%) presented an FEV1/FVC ratio below lower limit of normal (Z-score = -1.645) indicative of an obstructive airway disease. Following inhalation of a β2-adrenergic agonist we measured a mean FEV1 increase of 181.5 mL in our cohort, which was significantly elevated compared to a historical control group (ΔFEV1 = 118 mL). 28.7% of the patients showed an increase greater than 200 mL and 12% displayed a significant bronchodilation response (>200 mL ΔFEV1 and >12% FEV1 increase). Interestingly, no significant difference in bronchial dilation effect was observed when comparing patients hospitalized and those non-hospitalized during the course of their SARS-CoV-2 infection.
Our data provide evidence for increased prevalence of obstructive ventilatory defects and increased bronchodilator responsiveness in patients with persisting symptoms after COVID-19. Depending on the extent of this complication, post-COVID patients may benefit from an adapted β2-inhalation therapy including subsequent reevaluation.
SARS-CoV-2 感染可导致从轻度到危及生命的广泛症状。然而，人们对其对肺功能的长期影响仍了解甚少。
在我们的研究中，我们检查了 134 名患有 COVID-19 后出现呼吸困难的患者（年龄 54.83±14.4 岁），这些患者在 SARS-CoV-2 感染后 6 周到 24 个月期间在我们的肺康复诊所住院，他们的主要症状是用力呼吸困难。我们检查了这些患者在支气管扩张剂治疗前的支气管扩张反应性。
在支气管扩张前，134 名患者中有 6 名（4.47%）的 FEV1/FVC 比值低于正常下限（Z 分数=-1.645），提示存在阻塞性气道疾病。在吸入β2-肾上腺素能激动剂后，我们测量了本队列的平均 FEV1 增加 181.5mL，与历史对照组相比（ΔFEV1=118mL）明显升高。28.7%的患者的增加量大于 200mL，12%的患者表现出显著的支气管扩张反应（>200mLΔFEV1和>12%FEV1 增加）。有趣的是，在比较住院和非住院期间 SARS-CoV-2 感染的患者时，支气管扩张效果没有显著差异。
我们的数据提供了证据，表明 COVID-19 后持续存在症状的患者中，阻塞性通气缺陷和支气管扩张剂反应性增加的患病率增加。根据这种并发症的严重程度，COVID-19 后患者可能受益于适应性的β2-吸入治疗，包括随后的重新评估。
