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Impact of impaired pulmonary function on clinical outcomes in survivors of severe COVID-19 without pre-existing respiratory disease

OBJECTIVE: To investigate the impact of impaired pulmonary function on patient-centered outcomes after hospital discharge due to severe COVID-19 in patients without preexisting respiratory disease. METHODS: This is an ongoing prospective cohort study evaluating patients (> 18 years of age) 2-6 mo...

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Autores principales: Benedetto, Igor Gorski, da Silva, Ravena Maya Cardoso, Hetzel, Guilherme Moreira, Viana, Gabriel da Silva, Guimarães, Amanda Reis, Folador, Luciano, Brentano, Vicente Bohrer, Garcia, Tiago Severo, Ribeiro, Sergio Pinto, Dalcin, Paulo de Tarso Roth, Gazzana, Marcelo Basso, Berton, Danilo Cortozi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Pneumologia e Tisiologia 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10578918/
https://www.ncbi.nlm.nih.gov/pubmed/37255163
http://dx.doi.org/10.36416/1806-3756/e20220452
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author Benedetto, Igor Gorski
da Silva, Ravena Maya Cardoso
Hetzel, Guilherme Moreira
Viana, Gabriel da Silva
Guimarães, Amanda Reis
Folador, Luciano
Brentano, Vicente Bohrer
Garcia, Tiago Severo
Ribeiro, Sergio Pinto
Dalcin, Paulo de Tarso Roth
Gazzana, Marcelo Basso
Berton, Danilo Cortozi
author_facet Benedetto, Igor Gorski
da Silva, Ravena Maya Cardoso
Hetzel, Guilherme Moreira
Viana, Gabriel da Silva
Guimarães, Amanda Reis
Folador, Luciano
Brentano, Vicente Bohrer
Garcia, Tiago Severo
Ribeiro, Sergio Pinto
Dalcin, Paulo de Tarso Roth
Gazzana, Marcelo Basso
Berton, Danilo Cortozi
author_sort Benedetto, Igor Gorski
collection PubMed
description OBJECTIVE: To investigate the impact of impaired pulmonary function on patient-centered outcomes after hospital discharge due to severe COVID-19 in patients without preexisting respiratory disease. METHODS: This is an ongoing prospective cohort study evaluating patients (> 18 years of age) 2-6 months after hospital discharge due to severe COVID-19. Respiratory symptoms, health-related quality of life, lung function, and the six-minute walk test were assessed. A restrictive ventilatory defect was defined as TLC below the lower limit of normal, as assessed by plethysmography. Chest CT scans performed during hospitalization were scored for the presence and extent of parenchymal abnormalities. RESULTS: At a mean follow-up of 17.2 ± 5.9 weeks after the diagnosis of COVID-19, 120 patients were assessed. Of those, 23 (19.2%) reported preexisting chronic respiratory diseases and presented with worse lung function and exertional dyspnea at the follow-up visit in comparison with their counterparts. When we excluded the 23 patients with preexisting respiratory disease plus another 2 patients without lung volume measurements, a restrictive ventilatory defect was observed in 42/95 patients (44%). This subgroup of patients (52.4% of whom were male; mean age, 53.9 ± 11.3 years) showed reduced resting gas exchange efficiency (DL(CO)), increased daily-life dyspnea, increased exertional dyspnea and oxygen desaturation, and reduced health-related quality of life in comparison with those without reduced TLC (50.9% of whom were male; mean age, 58.4 ± 11.3 years). Intensive care need and higher chest CT scores were associated with a subsequent restrictive ventilatory defect. CONCLUSIONS: The presence of a restrictive ventilatory defect approximately 4 months after severe COVID-19 in patients without prior respiratory comorbidities implies worse clinical outcomes.
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spelling pubmed-105789182023-10-17 Impact of impaired pulmonary function on clinical outcomes in survivors of severe COVID-19 without pre-existing respiratory disease Benedetto, Igor Gorski da Silva, Ravena Maya Cardoso Hetzel, Guilherme Moreira Viana, Gabriel da Silva Guimarães, Amanda Reis Folador, Luciano Brentano, Vicente Bohrer Garcia, Tiago Severo Ribeiro, Sergio Pinto Dalcin, Paulo de Tarso Roth Gazzana, Marcelo Basso Berton, Danilo Cortozi J Bras Pneumol Original Article OBJECTIVE: To investigate the impact of impaired pulmonary function on patient-centered outcomes after hospital discharge due to severe COVID-19 in patients without preexisting respiratory disease. METHODS: This is an ongoing prospective cohort study evaluating patients (> 18 years of age) 2-6 months after hospital discharge due to severe COVID-19. Respiratory symptoms, health-related quality of life, lung function, and the six-minute walk test were assessed. A restrictive ventilatory defect was defined as TLC below the lower limit of normal, as assessed by plethysmography. Chest CT scans performed during hospitalization were scored for the presence and extent of parenchymal abnormalities. RESULTS: At a mean follow-up of 17.2 ± 5.9 weeks after the diagnosis of COVID-19, 120 patients were assessed. Of those, 23 (19.2%) reported preexisting chronic respiratory diseases and presented with worse lung function and exertional dyspnea at the follow-up visit in comparison with their counterparts. When we excluded the 23 patients with preexisting respiratory disease plus another 2 patients without lung volume measurements, a restrictive ventilatory defect was observed in 42/95 patients (44%). This subgroup of patients (52.4% of whom were male; mean age, 53.9 ± 11.3 years) showed reduced resting gas exchange efficiency (DL(CO)), increased daily-life dyspnea, increased exertional dyspnea and oxygen desaturation, and reduced health-related quality of life in comparison with those without reduced TLC (50.9% of whom were male; mean age, 58.4 ± 11.3 years). Intensive care need and higher chest CT scores were associated with a subsequent restrictive ventilatory defect. CONCLUSIONS: The presence of a restrictive ventilatory defect approximately 4 months after severe COVID-19 in patients without prior respiratory comorbidities implies worse clinical outcomes. Sociedade Brasileira de Pneumologia e Tisiologia 2023-05-11 /pmc/articles/PMC10578918/ /pubmed/37255163 http://dx.doi.org/10.36416/1806-3756/e20220452 Text en © 2023 Sociedade Brasileira de Pneumologia e Tisiologia https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License which permits unrestricted non-commercial use, distribution, and reproduction in any medium provided the original work is properly cited.
spellingShingle Original Article
Benedetto, Igor Gorski
da Silva, Ravena Maya Cardoso
Hetzel, Guilherme Moreira
Viana, Gabriel da Silva
Guimarães, Amanda Reis
Folador, Luciano
Brentano, Vicente Bohrer
Garcia, Tiago Severo
Ribeiro, Sergio Pinto
Dalcin, Paulo de Tarso Roth
Gazzana, Marcelo Basso
Berton, Danilo Cortozi
Impact of impaired pulmonary function on clinical outcomes in survivors of severe COVID-19 without pre-existing respiratory disease
title Impact of impaired pulmonary function on clinical outcomes in survivors of severe COVID-19 without pre-existing respiratory disease
title_full Impact of impaired pulmonary function on clinical outcomes in survivors of severe COVID-19 without pre-existing respiratory disease
title_fullStr Impact of impaired pulmonary function on clinical outcomes in survivors of severe COVID-19 without pre-existing respiratory disease
title_full_unstemmed Impact of impaired pulmonary function on clinical outcomes in survivors of severe COVID-19 without pre-existing respiratory disease
title_short Impact of impaired pulmonary function on clinical outcomes in survivors of severe COVID-19 without pre-existing respiratory disease
title_sort impact of impaired pulmonary function on clinical outcomes in survivors of severe covid-19 without pre-existing respiratory disease
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10578918/
https://www.ncbi.nlm.nih.gov/pubmed/37255163
http://dx.doi.org/10.36416/1806-3756/e20220452
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