Medium-term impact of COVID-19 on pulmonary function, functional capacity and quality of life

Fabio Anastasio, Sarah Barbuto, Elisa Scarnecchia, Paolo Cosma, Alessandro Fugagnoli, Giulio Rossi, Mirco Parravicini, Pierpaolo Parravicini, Fabio Anastasio, Sarah Barbuto, Elisa Scarnecchia, Paolo Cosma, Alessandro Fugagnoli, Giulio Rossi, Mirco Parravicini, Pierpaolo Parravicini

Abstract

Background: Coronavirus disease 2019 (COVID-19) has spread worldwide, having a dramatic impact on healthcare systems. The aim of this study is to evaluate mid-term clinical impact of COVID-19 on respiratory function.

Methods: 379 patients were evaluated 4 months after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diagnosis. Patients were divided in two groups based on the presence of pneumonia during COVID-19. Clinical conditions, quality of life, symptomatology, 6-min walk test, pulmonary function test with spirometry and diffusing capacity of the lung for carbon monoxide were analysed. Data were compared to clinical evolution during COVID-19 (development of acute respiratory distress syndrome, need of invasive mechanical ventilation, partial oxygen saturation (S pO2 )/inspiratory oxygen fraction (F IO2 ) ratio and pneumonia severity index (PSI)).

Results: After a median 135 days, 260 (68.6%) out of 379 patients referred at least one symptom. Patients who developed pneumonia during COVID-19 showed lower S pO2 at rest (p<0.001), S pO2 during 6-min walk test (p<0.001), total lung capacity (p<0.001), airway occlusion pressure after 0.1 s (P 0.1) (p=0.02), P 0.1/maximal inspiratory pressure ratio (p=0.005) and higher Borg category-ratio scale (p=0.006) and modified Medical Research Council breathlessness scale (p=0.003), compared to patients without pneumonia. S pO2 /F IO2 ratio and PSI during SARS-CoV-2 pneumonia were directly associated with mid-term alteration of S pO2 at rest (p<0.001) and during 6-min walk test (p<0.001), residual volume (p<0.001), total lung capacity (p<0.001 and p=0.003, respectively) and forced vital capacity (p=0.004 and p=0.03, respectively).

Conclusion: Lung damage during COVID-19 correlates to the reduction of pulmonary function 4 months after acute infection.

Conflict of interest statement

Conflict of interest: F. Anastasio has nothing to disclose. Conflict of interest: S. Barbuto has nothing to disclose. Conflict of interest: E. Scarnecchia has nothing to disclose. Conflict of interest: P. Cosma has nothing to disclose. Conflict of interest: A. Fugagnoli has nothing to disclose. Conflict of interest: G. Rossi has nothing to disclose. Conflict of interest: M. Parravicini has nothing to disclose. Conflict of interest: P. Parravicini has nothing to disclose.

Copyright ©The authors 2021.

Figures

FIGURE 1
FIGURE 1
Scatter plot showing significant correlation between partial oxygen saturation (SpO2)/inspiratory oxygen fraction (FIO2) ratio during severe acute respiratory syndrome coronavirus 2 disease and pulmonary function and 6-min walk test (6MWT) parameters. TLC: total lung capacity; RV: residual volume; FVC: forced vital capacity; MEP: maximal expiratory pressure.
FIGURE 2
FIGURE 2
Scatter plot showing significant correlation between time since diagnosis and a) 6-min walk distance (6MWD) and b) diffusing capacity of the lung for carbon monoxide (DLCO)/alveolar volume (VA) ratio.

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