Cargando…
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...
Autores principales: | , , , , , , , , , , , |
---|---|
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 |
_version_ | 1785121615923642368 |
---|---|
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. |
format | Online Article Text |
id | pubmed-10578918 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Sociedade Brasileira de Pneumologia e Tisiologia |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT benedettoigorgorski impactofimpairedpulmonaryfunctiononclinicaloutcomesinsurvivorsofseverecovid19withoutpreexistingrespiratorydisease AT dasilvaravenamayacardoso impactofimpairedpulmonaryfunctiononclinicaloutcomesinsurvivorsofseverecovid19withoutpreexistingrespiratorydisease AT hetzelguilhermemoreira impactofimpairedpulmonaryfunctiononclinicaloutcomesinsurvivorsofseverecovid19withoutpreexistingrespiratorydisease AT vianagabrieldasilva impactofimpairedpulmonaryfunctiononclinicaloutcomesinsurvivorsofseverecovid19withoutpreexistingrespiratorydisease AT guimaraesamandareis impactofimpairedpulmonaryfunctiononclinicaloutcomesinsurvivorsofseverecovid19withoutpreexistingrespiratorydisease AT foladorluciano impactofimpairedpulmonaryfunctiononclinicaloutcomesinsurvivorsofseverecovid19withoutpreexistingrespiratorydisease AT brentanovicentebohrer impactofimpairedpulmonaryfunctiononclinicaloutcomesinsurvivorsofseverecovid19withoutpreexistingrespiratorydisease AT garciatiagosevero impactofimpairedpulmonaryfunctiononclinicaloutcomesinsurvivorsofseverecovid19withoutpreexistingrespiratorydisease AT ribeirosergiopinto impactofimpairedpulmonaryfunctiononclinicaloutcomesinsurvivorsofseverecovid19withoutpreexistingrespiratorydisease AT dalcinpaulodetarsoroth impactofimpairedpulmonaryfunctiononclinicaloutcomesinsurvivorsofseverecovid19withoutpreexistingrespiratorydisease AT gazzanamarcelobasso impactofimpairedpulmonaryfunctiononclinicaloutcomesinsurvivorsofseverecovid19withoutpreexistingrespiratorydisease AT bertondanilocortozi impactofimpairedpulmonaryfunctiononclinicaloutcomesinsurvivorsofseverecovid19withoutpreexistingrespiratorydisease |