Lung function and breathing patterns in hospitalised COVID-19 survivors: a review of post-COVID-19 Clinics.
Abstract
Introduction: There is relatively little published on the effects of COVID-19 on respiratory physiology, particularly breathing patterns. We sought to determine if there were lasting detrimental effect following hospital discharge and if these related to the severity of COVID-19.
Methods: We reviewed lung function and breathing patterns in COVID-19 survivors > 3 months after discharge, comparing patients who had been admitted to the intensive therapy unit (ITU) (n = 47) to those who just received ward treatments (n = 45). Lung function included spirometry and gas transfer and breathing patterns were measured with structured light plethysmography. Continuous data were compared with an independent t-test or Mann Whitney-U test (depending on distribution) and nominal data were compared using a Fisher's exact test (for 2 categories in 2 groups) or a chi-squared test (for > 2 categories in 2 groups). A p-value of < 0.05 was taken to be statistically significant.
Results: We found evidence of pulmonary restriction (reduced vital capacity and/or alveolar volume) in 65.4% of all patients. 36.1% of all patients has a reduced transfer factor (TLCO) but the majority of these (78.1%) had a preserved/increased transfer coefficient (KCO), suggesting an extrapulmonary cause. There were no major differences between ITU and ward lung function, although KCO alone was higher in the ITU patients (p = 0.03). This could be explained partly by obesity, respiratory muscle fatigue, localised microvascular changes, or haemosiderosis from lung damage. Abnormal breathing patterns were observed in 18.8% of subjects, although no consistent pattern of breathing pattern abnormalities was evident.
Conclusions: An "extrapulmonary restrictive" like pattern appears to be a common phenomenon in previously admitted COVID-19 survivors. Whilst the cause of this is not clear, the effects seem to be similar on patients whether or not they received mechanical ventilation or had ward based respiratory support/supplemental oxygen.
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Date
2021-09-27
Type
Article
Subject
Intensive care
Collections
Citation
Stockley JA, Alhuthail EA, Coney AM, Parekh D, Geberhiwot T, Gautum N, Madathil SC, Cooper BG. Lung function and breathing patterns in hospitalised COVID-19 survivors: a review of post-COVID-19 Clinics. Respir Res. 2021 Sep 27;22(1):255. doi: 10.1186/s12931-021-01834-5
Journal / Source Title
Respiratory Research
DOI
10.1186/s12931-021-01834-5
PMID
34579722
Publisher
BioMed Central
Publisher’s URL
https://respiratory-research.biomedcentral.com/