Impact of coronavirus disease 2019 on pulmonary function in early convalescence phase

Yiying Huang, Cuiyan Tan, Jian Wu, Meizhu Chen, Zhenguo Wang, Liyun Luo, Xiaorong Zhou, Xinran Liu, Xiaoling Huang, Shican Yuan, Chaolin Chen, Fen Gao, Jin Huang, Hong Shan, Jing Liu, Yiying Huang, Cuiyan Tan, Jian Wu, Meizhu Chen, Zhenguo Wang, Liyun Luo, Xiaorong Zhou, Xinran Liu, Xiaoling Huang, Shican Yuan, Chaolin Chen, Fen Gao, Jin Huang, Hong Shan, Jing Liu

Abstract

Objective: This study investigated the influence of Coronavirus Disease 2019 (COVID-19) on lung function in early convalescence phase.

Methods: A retrospective study of COVID-19 patients at the Fifth Affiliated Hospital of Sun Yat-sen University were conducted, with serial assessments including lung volumes (TLC), spirometry (FVC, FEV1), lung diffusing capacity for carbon monoxide (DLCO),respiratory muscle strength, 6-min walking distance (6MWD) and high resolution CT being collected at 30 days after discharged.

Results: Fifty-seven patients completed the serial assessments. There were 40 non-severe cases and 17 severe cases. Thirty-one patients (54.3%) had abnormal CT findings. Abnormalities were detected in the pulmonary function tests in 43 (75.4%) of the patients. Six (10.5%), 5(8.7%), 25(43.8%) 7(12.3%), and 30 (52.6%) patients had FVC, FEV1, FEV1/FVC ratio, TLC, and DLCO values less than 80% of predicted values, respectively. 28 (49.1%) and 13 (22.8%) patients had PImax and PEmax values less than 80% of the corresponding predicted values. Compared with non-severe cases, severe patients showed higher incidence of DLCO impairment (75.6%vs42.5%, p = 0.019), higher lung total severity score (TSS) and R20, and significantly lower percentage of predicted TLC and 6MWD. No significant correlation between TSS and pulmonary function parameters was found during follow-up visit.

Conclusion: Impaired diffusing-capacity, lower respiratory muscle strength, and lung imaging abnormalities were detected in more than half of the COVID-19 patients in early convalescence phase. Compared with non-severe cases, severe patients had a higher incidence of DLCO impairment and encountered more TLC decrease and 6MWD decline.

Keywords: COVID-19; Early convalescence; Lung function; Respiratory muscle strength.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Enrollment of COVID-19 patients in Early Convalescence
Fig. 2
Fig. 2
HRCT scan of a 44-year-old man in acute stage demonstrated bilateral peripheral ground-glass opacities (GGO). Lung total severity score (TSS)was 7. B. Follow-up CT of the same patient at 30 days after discharge from hospital showed that patchy ground glass opacity had obvious absorption.TSS was 3 .C. Worst CT scan of a severe patient during acute stage showed diffuse GGO, consolidation also could be seen in some area. TSS was 13. D: HRCT scan of the same patient obtained 30 days after discharge showed peripheral fibrosis consists of irregular linear opacities. Concomitant presence of GGO was also visible.TSS is 5
Fig. 3
Fig. 3
Correlation of total severity score on worst CT (from a1 to h1) and follow-up CT (from a2 to h2) with pulmonary function parameters.

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Source: PubMed

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