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Characterization of adolescents with functional respiratory disorders and prior history of SARS-CoV-2

BACKGROUND: The SARS-CoV-2 pandemic has caused significant pulmonary morbidity and mortality in the adult population. Children and adolescents typically show milder symptoms; however, a relevant proportion of them report persistent pulmonary symptoms even after mild SARS-CoV-2 infection. Functional...

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Autores principales: Bode, Sebastian Felix Nepomuk, Schwender, Anja, Toth, Monika, Kaeppler-Schorn, Christine, Siebeneich, Ute, Freihorst, Joachim, Janda, Ales, Fabricius, Dorit
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10497462/
https://www.ncbi.nlm.nih.gov/pubmed/37698705
http://dx.doi.org/10.1186/s40348-023-00165-3
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author Bode, Sebastian Felix Nepomuk
Schwender, Anja
Toth, Monika
Kaeppler-Schorn, Christine
Siebeneich, Ute
Freihorst, Joachim
Janda, Ales
Fabricius, Dorit
author_facet Bode, Sebastian Felix Nepomuk
Schwender, Anja
Toth, Monika
Kaeppler-Schorn, Christine
Siebeneich, Ute
Freihorst, Joachim
Janda, Ales
Fabricius, Dorit
author_sort Bode, Sebastian Felix Nepomuk
collection PubMed
description BACKGROUND: The SARS-CoV-2 pandemic has caused significant pulmonary morbidity and mortality in the adult population. Children and adolescents typically show milder symptoms; however, a relevant proportion of them report persistent pulmonary symptoms even after mild SARS-CoV-2 infection. Functional respiratory disorders may be relevant differential diagnoses of persistent dyspnea. This study aims at characterizing functional respiratory disorders that may arise after SARS-CoV-2 infection regarding their clinical presentation and pulmonary function tests as well as gaining insights into the clinical course after initiation of appropriate therapy. METHODS: This study retrospectively identified all patients referred to an outpatient clinic for pediatric pulmonology with functional respiratory disorders manifesting after proven SARS-CoV-2 infection between January 1, 2022, and October 31, 2022. Clinical history, thorough clinical examination regarding breathing patterns, and pulmonary function tests (PFTs) were taken into consideration to diagnose functional respiratory disorders. RESULTS: Twenty-five patients (44% female) with mean (m) age = 12.73 years (SD ± 1.86) who showed distinctive features of functional respiratory disorders after SARS-CoV-2 infection (onset at m = 4.15 (± 4.24) weeks after infection) were identified. Eleven patients showed thoracic dominant breathing with insufficient ventilation, and 4 patients mainly had symptoms of inducible laryngeal obstruction. The rest (n = 10) showed overlap of these two etiologies. Most patients had a flattened inspiratory curve on spirometry and slightly elevated residual volume on body plethysmography, but values of PFTs were normal before and after standardized treadmill exercise testing. Patients were educated about the benign nature of the condition and were offered rebreathing training. All patients with follow-up (n = 5) showed normalization of the breathing pattern within 3 months. CONCLUSIONS: Functional respiratory disorders are important differential diagnoses in persisting post-SARS-CoV-2 dyspnea in adolescents. A combination of clinical history, detailed examination of breathing patterns, and pulmonary function tests are helpful to correctly diagnose these conditions. Reassurance and rebreathing training are the mainstay of the therapy. The clinical course is favorable.
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spelling pubmed-104974622023-09-14 Characterization of adolescents with functional respiratory disorders and prior history of SARS-CoV-2 Bode, Sebastian Felix Nepomuk Schwender, Anja Toth, Monika Kaeppler-Schorn, Christine Siebeneich, Ute Freihorst, Joachim Janda, Ales Fabricius, Dorit Mol Cell Pediatr Research BACKGROUND: The SARS-CoV-2 pandemic has caused significant pulmonary morbidity and mortality in the adult population. Children and adolescents typically show milder symptoms; however, a relevant proportion of them report persistent pulmonary symptoms even after mild SARS-CoV-2 infection. Functional respiratory disorders may be relevant differential diagnoses of persistent dyspnea. This study aims at characterizing functional respiratory disorders that may arise after SARS-CoV-2 infection regarding their clinical presentation and pulmonary function tests as well as gaining insights into the clinical course after initiation of appropriate therapy. METHODS: This study retrospectively identified all patients referred to an outpatient clinic for pediatric pulmonology with functional respiratory disorders manifesting after proven SARS-CoV-2 infection between January 1, 2022, and October 31, 2022. Clinical history, thorough clinical examination regarding breathing patterns, and pulmonary function tests (PFTs) were taken into consideration to diagnose functional respiratory disorders. RESULTS: Twenty-five patients (44% female) with mean (m) age = 12.73 years (SD ± 1.86) who showed distinctive features of functional respiratory disorders after SARS-CoV-2 infection (onset at m = 4.15 (± 4.24) weeks after infection) were identified. Eleven patients showed thoracic dominant breathing with insufficient ventilation, and 4 patients mainly had symptoms of inducible laryngeal obstruction. The rest (n = 10) showed overlap of these two etiologies. Most patients had a flattened inspiratory curve on spirometry and slightly elevated residual volume on body plethysmography, but values of PFTs were normal before and after standardized treadmill exercise testing. Patients were educated about the benign nature of the condition and were offered rebreathing training. All patients with follow-up (n = 5) showed normalization of the breathing pattern within 3 months. CONCLUSIONS: Functional respiratory disorders are important differential diagnoses in persisting post-SARS-CoV-2 dyspnea in adolescents. A combination of clinical history, detailed examination of breathing patterns, and pulmonary function tests are helpful to correctly diagnose these conditions. Reassurance and rebreathing training are the mainstay of the therapy. The clinical course is favorable. Springer International Publishing 2023-09-12 /pmc/articles/PMC10497462/ /pubmed/37698705 http://dx.doi.org/10.1186/s40348-023-00165-3 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Research
Bode, Sebastian Felix Nepomuk
Schwender, Anja
Toth, Monika
Kaeppler-Schorn, Christine
Siebeneich, Ute
Freihorst, Joachim
Janda, Ales
Fabricius, Dorit
Characterization of adolescents with functional respiratory disorders and prior history of SARS-CoV-2
title Characterization of adolescents with functional respiratory disorders and prior history of SARS-CoV-2
title_full Characterization of adolescents with functional respiratory disorders and prior history of SARS-CoV-2
title_fullStr Characterization of adolescents with functional respiratory disorders and prior history of SARS-CoV-2
title_full_unstemmed Characterization of adolescents with functional respiratory disorders and prior history of SARS-CoV-2
title_short Characterization of adolescents with functional respiratory disorders and prior history of SARS-CoV-2
title_sort characterization of adolescents with functional respiratory disorders and prior history of sars-cov-2
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10497462/
https://www.ncbi.nlm.nih.gov/pubmed/37698705
http://dx.doi.org/10.1186/s40348-023-00165-3
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