Pulmonary long-term consequences of COVID-19 infections after hospital discharge.

OBJECTIVES: Coronavirus disease 2019 (COVID-19) survivors are reporting residual abnormalities after discharge from hospital. Limited information is available about this stage of recovery or the lingering effects of the virus on pulmonary function and inflammation. This study aimed to describe lung function in patients recovering from COVID-19 hospitalization and to identify biomarkers in serum and induced sputum samples from these patients. METHODS: Patients admitted to Spanish hospitals with laboratory-confirmed COVID-19 infection by a real-time PCR (RT-PCR) assay for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were recruited for this study. Each hospital screened their lists of discharged patients at least 45 days after symptom onset. SARS-CoV-2-infected patients were divided into mild/moderate and severe disease groups according to the severity of their symptoms during hospitalization. Patients' epidemiological and medical histories, comorbidities, chronic treatments, and laboratory parameters were evaluated. Pulmonary function tests, the standardized 6-minute walk test (6MWT) and chest computed tomography (CT) were also performed. The levels of proteases, their inhibitors, and shed receptors were measured in serum and induced sputum samples. RESULTS: A total of 100 patients with respiratory function tests were included in this study. The median number of days after the onset of symptoms was 104 (IQR 89.25, 126.75). COVID-19 was severe in 47% of patients (47/100). CT was normal in 48% of patients (48/100). Lung function was normal forced expiratory volume in one second (FEV1) ≥80%, forced vital capacity (FVC) ≥80%, FEV1/FVC ≥0.7, and diffusing capacity for carbon monoxide (DLCO) ≥80% in 92% (92/100), 94% (94/100), 100% (100/100) and 48% (48/100) of patients, respectively. Multivariate analysis showed that a DLCO <80% (OR 5.92; 95%CI 2.28-15.37; p < 0.0001) and a lower serum lactate dehydrogenase level (OR 0.98; 95%CI 0.97-0.99) were associated with the severe disease group of SARS-CoV-2 cases during hospital stay. CONCLUSIONS: A diffusion deficit (DLCO <80%) was still present after hospital discharge and was associated with the most severe SARS-CoV-2 cases.

Respuesta. Síndrome de apnea obstructiva durante el sueño y cortocircuito derecha-izquierda late / Reply. Obstructive sleep apnea syndrome and right-to-left shunt

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[Factors with influence on sleep apnea/hypopnea syndrome]. / Factores que influyen en el síndrome de apneas-hipopneas durante el sueño.

BACKGROUND AND OBJECTIVE: Evaluate the influence of some variables (gender, age, alcohol intake and obesity) on the apnea/hypopnea index (AHI) in patients with sleep apnea/hypopnea syndrome (SAHS). PATIENTS AND METHOD: We retrospectively reviewed medical records of patients with SAHS in the Hospital General Universitario of Murcia. We assessed demographic variables, alcohol intake, Epworth's scale, obesity and cardiorespiratory polygraphy or polysomnography. A multivariate regression model was used to explain the AHI in relation with other variables. RESULTS: We reviewed 127 medical records of patients with SAHS. Alcohol intake was the most powerful variable influencing the AHI, followed by the numeric value of the Epworth's Scale. No statistical significance was found with regard to the the rest of variables. CONCLUSIONS: In patients with SAHS, the AHI can be related to the alcohol intake and the numeric value of Epworth's Scale.

Factores que influyen en el síndrome de apneas-hipopneas durante el sueño / Factors with Influence on Sleep Apnea/Hypopnea Syndrome

Fundamento y objetivo: Evaluar la influencia de determinados factores, como el sexo, la edad, el consumo de alcohol y la obesidad, sobre el valor del índice de apneas-hipopneas (IAH) en pacientes con síndrome de apneas-hipopneas durante el sueño (SAHS). Pacientes y método: Se han revisado de forma retrospectiva las historias clínicas de pacientes diagnosticados de SAHS en el Hospital General Universitario de Murcia. Se tomaron datos sobre variables demográficas, obesidad, consumo de alcohol, somnolencia (escala de Epworth) y poligrafía cardiorrespiratoria o polisomnografía. A los datos obtenidos se les aplicó un modelo de regresión multivariante para explicar la variable IAH en función de diversas características. Resultados: Se estudió 127 historias clínicas de pacientes diagnosticados de SAHS. En nuestro trabajo, la variable que tiene mayor poder explicativo del comportamiento del IAH en pacientes diagnosticados de SAHS es el consumo de alcohol; la siguiente en importancia es el valor numérico de la escala de Epworth. Las demás variables tienen una influencia estadísticamente no significativa. Conclusiones: El valor del IAH en pacientes diagnosticados de SAHS podría estar relacionado con el consumo de alcohol y con el valor numérico de la escala de Epworth

Background and objective: Evaluate the influence of some variables (gender, age, alcohol intake and obesity) on the apnea/hypopnea index (AHI) in patients with sleep apnea/hypopnea syndrome (SAHS). Patients and Method: We retrospectively reviewed medical records of patients with SAHS in the Hospital General Universitario of Murcia. We assessed demographic variables, alcohol intake, Epworth's scale, obesity and cardiorespiratory polygraphy or polysomnography. A multivariate regression model was used to explain the AHI in relation with other variables. Results: We reviewed 127 medical records of patients with SAHS. Alcohol intake was the most powerful variable influencing the AHI, followed by the numeric value of the Epworth's Scale. No statistical significance was found with regard to the the rest of variables. Conclusions: In patients with SAHS, the AHI can be related to the alcohol intake and the numeric value of Epworth's Scale