Relation of impulse oscillometry and spirometry with quantitative thorax computed tomography after COVID-19 pneumonia.

OBJECTIVE: This study aimed to investigate if there is any correlation between the quantitative computed tomography and the impulse oscillometry or spirometry results of post-COVID-19 patients. METHODS: The study comprised 47 post-COVID-19 patients who had spirometry, impulse oscillometry, and high-resolution computed tomography examinations at the same time. The study group consisted of 33 patients with quantitative computed tomography involvement, while the control group included 14 patients who did not have CT findings. The quantitative computed tomography technology was used to calculate percentages of density range volumes. The relationship between percentages of density range volumes for different quantitative computed tomography density ranges and impulse oscillometry-spirometry findings was statistically analyzed. RESULTS: In quantitative computed tomography, the percentage of relatively high-density lung parenchyma, including fibrotic areas, was 1.76±0.43 and 5.65±3.73 in the control and study groups, respectively. The percentages of primarily ground-glass parenchyma areas were found to be 7.60±2.86 and 29.25±16.50 in the control and study groups, respectively. In the correlation analysis, the forced vital capacity% predicted in the study group was correlated with DRV%[(-750)-(-500)] (volume of the lung parenchyma that has density between (-750)-(-500) Hounsfield units), but no correlation with DRV%[(-500)-0] was detected. Also, reactance area and resonant frequency were correlated with DRV%[(-750)-(-500)], while X5 was correlated with both DRV%[(-500)-0] and DRV%[(-750)-(-500)] density. Modified Medical Research Council score was correlated with predicted percentages of forced vital capacity and X5. CONCLUSION: After COVID-19, forced vital capacity, reactance area, resonant frequency, and X5 correlated with the percentages of density range volumes of ground-glass opacity areas in the quantitative computed tomography. X5 was the only parameter correlated with density ranges consistent with both ground-glass opacity and fibrosis. Furthermore, the percentages of forced vital capacity and X5 were shown to be associated with the perception of dyspnea.

Relationship between exercise capacity and impulse oscillometry parameters after COVID-19 infections.

BACKGROUND: After COVID-19 infection, persistent exercise intolerance, changes in lung function have been shown. Our aim is to investigate the correlation between impulse oscillometry (IOS) parameters and exercise capacity by using incremental and endurance shuttle walk tests (ISWT, ESWT) and investigate the factors and parameters which might have an effect on both IOS parameters and exercise capacity tests. METHOD: The patients who had a history of COVID-19 were enrolled into cross-sectional study according to inclusion criteria. The IOS parameters, ISWT, ESWT, smoking status, time since COVID-19 diagnosis, length of hospital stay, forced vital capacity (FVC), forced expiratory volume in one second (FEV1), body mass index (BMI), fat-free mass index (FFMI), dyspnea, hospital anxiety-depression and fatigue severity scores were recorded. RESULTS: The study comprised 72 patients, 71% of whom were male, with a mean age of 54 ± 10 years. After COVID-19 diagnosis, the median duration was 3 (min: 1, max: 5) months and 51 (71%) of the patients were hospitalized. The FEV1 and FVC values were in normal range. The area of reactance (AX), resonance frequency (Fres), reactance at 20 Hz (X20) and the difference between resonance at 20 and 5 Hz (R5-20) correlated with both ISWT and ESWT. The FEV1 correlated with all IOS parameters (p < 0.05). Reactance correlated with FFMI (p = 024, r = 0.267), different according to hospitalization (p = 0.02). CONCLUSION: In COVID-19 survivors, there could be correlations between IOS parameters and exercise capacity; and between these parameters and FEV and FVC. Furthermore, small airway disease with normal spirometric functions could be related to decreased exercise capacity in COVID-19 survivors regardless of concomitant diseases, BMI, smoking status and time since COVID-19 diagnosis.

Tele-pulmonary rehabilitation with face to face in COVID-19 pandemic: A hybrid modeling.

Introduction: Post-illness pulmonary rehabilitation indications of Coronavirus disease-2019 (COVID-19) may include fatigue, respiratory restriction, exercise limitation, muscle weakness, deterioration in body composition, quality of life, and psychological status. Since tele-pulmonary rehabilitation (tele-PR) is the prominent approach in the current situation and questions such as who, how, and when are still unclear, in this study we aimed to investigate the efficacy of tele-PR as a hybrid model with face-to-face in post-COVID-19 patients. Materials and Methods: Thirty one patients who had completed viral infection treatment with the diagnosis of COVID-19 but still had persistent symptoms were enrolled in an eight-week synchronized video-conference mediated telePR program in a hybrid format, with the initial and final assessments and the first two sessions conducted in person. Before and after the tele-PR, pulmonary functions, exercise capacity, respiratory and peripheral muscle strength, body composition, quality of life, and psychological states were evaluated. Result: After the tele-PR program; a statistically significant improvement was observed in dyspnea sensation evaluated with modified Medical Research Council (mMRC) and BORG levels, body mass index (BMI), incremental shuttle walk test (ISWT), endurance shuttle walk test (ESWT), handgrip test, deltoid, and quadriceps 1-repetition maximum (1RM) results, maximal inspiratory and expiratory pressure (MIP, MEP), peripheral muscle strengths, fatigue severity scale and Nottingham extended activities of daily living scale (NEADLS). Conclusions: In this study, it has been shown that the hybrid model of tele-PR enables a comprehensive evaluation as well as the effective and safe applicability of a multidisciplinary and remotely directed program even in high workloads for post-COVID-19 patients.