Functional changes in the respiratory system after COVID-19-associated lung injury
A. V. Chernyak,
N. A. Karchevskaya,
O. I. Savushkina,
M. Kh. Mustafina,
E. A. Sinitsyn,
E. N. Kalmanova,
M. V. Samsonova,
E. A. Zaryanova,
K. A. Zykov https://doi.org/10.18093/0869-0189-2022-32-4-558-567
Abstract
Since the beginning of the pandemic, COVID-19 (COronaVIrus Disease-2019) has been viewed as a respiratory disease with characteristic symptoms including cough, shortness of breath, and difficulty breathing. However, some patients still have respiratory complaints and post-inflammatory changes in the lung tissue according to high-resolution computed tomography of the chest organs (CT scan) even after discharge from the hospital.
The aim. To assess the functional changes in the respiratory system in patients who had COVID-19-associated lung injury using a comprehensive testing of the respiratory function (spirometry, body plethysmography and diffusion test) in the first 6 months after discharge from the hospital.
Methods. The study included 434 patients (252 men and 182 women, aged 20 to 79 years), who were divided into 3 groups depending on the time interval between discharge from the hospital and the respiratory function test: Group 1 – 15 – 45 days; Group 2 – 46 – 93 days; Group 3 – 94 – 183 days. All patients underwent a comprehensive testing of respiratory function.
Results. The average pulmonary ventilation indicators remained within the normal range both in the general group and in separate groups. A decrease in DLCO was found in most patients: in 53% of people in the general group, in 54, 54 and 51% of cases in Groups 1, 2 and 3, respectively. Restrictive ventilation disorders (reduction of TLC below the lower limit of normal (LLN)) were detected in 29 % of people in the general group, 33, 27 and 26% in Groups 1, 2 and 3, respectively. Obstructive ventilation disorders (decrease in FEV1/FVC below LLN) were detected in 2 % in the general group, and in 3, 1 and 1% in groups 1, 2 and 3, respectively. Statistically significant correlations were found between the maximum volume of lung tissue damage in the acute period of COVID-19, the age of the patients, and the respiratory function indicators.
Conclusion. The pulmonary ventilation indicators normalized within 6 months after COVID-19, while a decrease in lung diffusion capacity persisted in most patients and required further active follow-up.
Keywords
post-COVID period,
respiratory system function,
spirometry,
lung diffusion capacity,
body plethysmography
Supporting agencies: The authors thank the doctors of the Department of Pulmonology, State Budgetary Healthcare Institution D.D.Pletnev City Clinical Hospital, Healthcare Department of Moscow for their assistance and participation in the study.
About the Authors
A. V. Chernyak
Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia; State Budgetary Healthcare Institution D. D. Pletnev City Clinical Hospital, Healthcare Department of Moscow
Russian Federation
Competing Interests:
Russian Federation
Aleksandr V. Chernyak, Candidate of Medicine, Head of Laboratory of Functional and Ultra-sound Investigations, Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia; Physician of Functional Diagnostics, Department of Functional and Ultrasound Diagnostics, State Budgetary Healthcare Institution D. D. Pletnev City Clinical Hospital, Health-care Department of Moscow
SPIN-код: 9328-6440; Author ID: 687383
28 Orehovyy bul’var, Moscow, 115682
ul. Odinnadtsataya Parkovaya 32, Moscow, 105077
tel.: (495) 395-63-93
Competing Interests:
The authors declare absence of conflict of interests.
N. A. Karchevskaya
Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia; N. V. Sklifosovskiy State Research Institute of Emergency Care, Moscow Healthcare Department
Russian Federation
Competing Interests:
Russian Federation
Natal’ya A. Karchevskaya, Рulmonologist, Researcher, Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia; Researcher, Department of thoraco-abdominal surgery, N. V. Sklifosovskiy State Research Institute of Emergency Care, Moscow Healthcare Department
28 Orehovyy bul’var, Moscow, 115682
Bolshaya Sukharevskaya pl. 3, Moscow, 129090
tel.: (495) 395-63-93
Competing Interests:
The authors declare absence of conflict of interests.
O. I. Savushkina
Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia; Main Military Clinical Hospital named after academician N. N. Burdenko, Ministry of Defense of the Russian Federation
Russian Federation
Competing Interests:
Russian Federation
Olga I. Savushkina, Candidate of Medicine, Senior Researcher, Laboratory of Functional and Ultrasound Research Methods, Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia; Head of the Department of External Respiratory Function Research, Center for Functional Diagnostic Research, Main Military Clinical Hospital named after academician N. N. Burdenko, Ministry of Defense of the Russian Federation
SPIN: 2988-8700; Author ID: 964904
28 Orehovyy bul’var, Moscow, 115682
Gospital’naya pl. 3, Moscow, 105229
tel.: (499) 263-28-61
Competing Interests:
The authors declare absence of conflict of interests.
M. Kh. Mustafina
Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia; Federal State Autonomous Educational Institution of Higher Education I. M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
Russian Federation
Competing Interests:
Russian Federation
Malika Kh. Mustafina, Candidate of Medicine, Researcher, Laboratory of Functional and Ultrasound Research Methods, Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia; Physician of Functional Diagnostics, Federal State Autonomous Educational Institution of Higher Education I. M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
SPIN: 6530-5830; Author ID: 687382
28 Orehovyy bul’var, Moscow, 115682
ul. Trubetskaya 8, build. 2, Moscow, 119991
tel.: (499) 248-34-77
Competing Interests:
The authors declare absence of conflict of interests.
E. A. Sinitsyn
Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia; Federal State Budgetary Educational Institution of Higher Education “A. I. Yevdokimov Moscow State University of Medicine and Dentistry” of the Ministry of Healthcare of the Russian Federation
Russian Federation
Competing Interests:
Russian Federation
Evgeny A. Sinitsyn, Chief Physician, Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia; Assistant of the Department of Faculty Therapy and Occupational Diseases, Federal State Budgetary Educational Institution of Higher Education “A. I. Yevdokimov Moscow State University of Medicine and Dentistry” of the Ministry of Healthcare of the Russian Federation
28 Orehovyy bul’var, Moscow, 115682
ul. Delegatskaya 20, build. 1, Moscow, 127473
tel.: (495) 395-63-93
Competing Interests:
The authors declare absence of conflict of interests.
E. N. Kalmanova
State Budgetary Healthcare Institution D. D. Pletnev City Clinical Hospital, Healthcare Department of Moscow
Russian Federation
Competing Interests:
Russian Federation
Elena N. Kalmanova, Candidate of Medicine, Head of the Department of Functional and Ultrasound Diagnostics
SPIN: 7286-1538; Author ID: 581036
ul. Odinnadtsataya Parkovaya 32, Moscow, 105077
tel.: (495) 965-34-66
Competing Interests:
The authors declare absence of conflict of interests.
M. V. Samsonova
Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia
Russian Federation
Competing Interests:
Russian Federation
Maria V. Samsonova, Doctor of Medicine, Head of Laboratory of Pathological Anatomy and Immunology
28 Orehovyy bul’var, Moscow, 115682
tel.: (495) 465-58-59
Competing Interests:
The authors declare absence of conflict of interests.
E. A. Zaryanova
Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia
Russian Federation
Competing Interests:
Russian Federation
Elena A. Zaryanova, Candidate of Medicine, Pulmonologist, Medical Center, Senior Researcher, Clinical Research Department
28 Orehovyy bul’var, Moscow, 115682
tel.: (495) 395-63-93
Competing Interests:
The authors declare absence of conflict of interests.
K. A. Zykov
Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia; Federal State Budgetary Educational Institution of Higher Education “A. I. Yevdokimov Moscow State University of Medicine and Dentistry” of the Ministry of Healthcare of the Russian Federation
Russian Federation
Competing Interests:
Russian Federation
Kirill A. Zykov, Doctor of Medicine, Professor, Corresponding Member of Russian Academy of Sciences, Deputy Director for Research and Innovation, Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia, Head of the Department of Faculty Therapy and Occupational Diseases, Federal State Budgetary Educational Institution of Higher Education “A. I. Yevdokimov Moscow State University of Medicine and Dentistry” of the Ministry of Healthcare of the Russian Federation
28 Orehovyy bul’var, Moscow, 115682
ul. Delegatskaya 20, build. 1, Moscow, 127473
tel.: (495) 395-63-93
Competing Interests:
The authors declare absence of conflict of interests.
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Chernyak A.V., Karchevskaya N.A., Savushkina O.I., Mustafina M.Kh., Sinitsyn E.A., Kalmanova E.N., Samsonova M.V., Zaryanova E.A., Zykov K.A. Functional changes in the respiratory system after COVID-19-associated lung injury. PULMONOLOGIYA. 2022;32(4):558-567. (In Russ.) https://doi.org/10.18093/0869-0189-2022-32-4-558-567
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