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Pulmonary function impairment of asymptomatic and persistently symptomatic patients 4 months after COVID-19 according to disease severity.
Munker, Dieter; Veit, Tobias; Barton, Jürgen; Mertsch, Pontus; Mümmler, Carlo; Osterman, Andreas; Khatamzas, Elham; Barnikel, Michaela; Hellmuth, Johannes C; Münchhoff, Maximilian; Walter, Julia; Ghiani, Alessandro; Munker, Stefan; Dinkel, Julien; Behr, Jürgen; Kneidinger, Nikolaus; Milger, Katrin.
  • Munker D; Department of Medicine V, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
  • Veit T; Comprehensive Pneumology Center Munich (CPC-M), Helmholtz Center and LMU Munich, Member of the German Center for Lung Research (DZL), Munich, Germany.
  • Barton J; Department of Medicine V, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
  • Mertsch P; Comprehensive Pneumology Center Munich (CPC-M), Helmholtz Center and LMU Munich, Member of the German Center for Lung Research (DZL), Munich, Germany.
  • Mümmler C; Department of Medicine V, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
  • Osterman A; Comprehensive Pneumology Center Munich (CPC-M), Helmholtz Center and LMU Munich, Member of the German Center for Lung Research (DZL), Munich, Germany.
  • Khatamzas E; Department of Medicine V, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
  • Barnikel M; Comprehensive Pneumology Center Munich (CPC-M), Helmholtz Center and LMU Munich, Member of the German Center for Lung Research (DZL), Munich, Germany.
  • Hellmuth JC; Department of Medicine V, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
  • Münchhoff M; Comprehensive Pneumology Center Munich (CPC-M), Helmholtz Center and LMU Munich, Member of the German Center for Lung Research (DZL), Munich, Germany.
  • Walter J; Max von Pettenkofer Institute and Gene Center, Virology, National Reference Center for Retroviruses, Ludwig Maximilian University (LMU) of Munich, Munich, Germany.
  • Ghiani A; German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany.
  • Munker S; Department of Medicine III, University Hospital, LMU Munich, Munich, Germany.
  • Dinkel J; Department of Medicine V, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
  • Behr J; Comprehensive Pneumology Center Munich (CPC-M), Helmholtz Center and LMU Munich, Member of the German Center for Lung Research (DZL), Munich, Germany.
  • Kneidinger N; Department of Medicine III, University Hospital, LMU Munich, Munich, Germany.
  • Milger K; COVID-19 Registry of the LMU Munich (CORKUM), University Hospital, Ludwig-Maximilians University Munich, Munich, Germany.
Infection ; 2021 Jul 28.
Article in English | MEDLINE | ID: covidwho-1330430
ABSTRACT

OBJECTIVE:

Evaluation of pulmonary function impairment after COVID-19 in persistently symptomatic and asymptomatic patients of all disease severities and characterisation of risk factors.

METHODS:

Patients with confirmed SARS-CoV-2 infection underwent prospective follow-up with pulmonary function testing and blood gas analysis during steady-state cycle exercise 4 months after acute illness. Pulmonary function impairment (PFI) was defined as reduction below 80% predicted of DLCOcSB, TLC, FVC, or FEV1. Clinical data were analyzed to identify risk factors for impaired pulmonary function.

RESULTS:

76 patients were included, hereof 35 outpatients with mild disease and 41 patients hospitalized due to COVID-19. Sixteen patients had critical disease requiring mechanical ventilation, 25 patients had moderate-severe disease. After 4 months, 44 patients reported persisting respiratory symptoms. Significant PFI was prevalent in 40 patients (52.6%) occurring among all disease severities. The most common cause for PFI was reduced DLCOcSB (n = 39, 51.3%), followed by reduced TLC and FVC. The severity of PFI was significantly associated with mechanical ventilation (p < 0.001). Further risk factors for DLCO impairment were COPD (p < 0.001), SARS-CoV-2 antibody-Titer (p = 0.014) and in hospitalized patients CT score. A decrease of paO2 > 3 mmHg during cycle exercise occurred in 1/5 of patients after mild disease course.

CONCLUSION:

We characterized pulmonary function impairment in asymptomatic and persistently symptomatic patients of different severity groups of COVID-19 and identified further risk factors associated with persistently decreased pulmonary function. Remarkably, gas exchange abnormalities were revealed upon cycle exercise in some patients with mild disease courses and no preexisting pulmonary condition.
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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Type of study: Diagnostic study / Prognostic study / Risk factors Language: English Clinical aspect: Etiology / Prediction / Prognosis Year: 2021

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Type of study: Diagnostic study / Prognostic study / Risk factors Language: English Clinical aspect: Etiology / Prediction / Prognosis Year: 2021
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