Dynamics of functional changes in the respiratory system after COVID-19-associated lung injury at one year after hospital discharge
https://doi.org/10.18093/0869-0189-2023-33-5-611-621
Abstract
Morphological examination reveals microcirculation disorders in combination with small areas of lung damage in the long term after COVID-19. Therefore, the function of the respiratory system should be assessed after COVID-19. Aim of this study was to evaluate the dynamics of respiratory dysfunction in patients with COVID-19-associated lung injury using a complex examination of lung function (spirometry, body plethysmography, and lung diffusion testing) one year after hospital discharge. Methods. 60 patients (38 men/22 women, aged 39 to 80 years) with a diagnosis of “COVID-19-associated interstitial process in the lungs” were examined. Lung function (spirometry, body plethysmography, and lung diffusion capacity testing) was examined in all patients twice, at 1 – 6 months (visit 1) and at 12 – 24 months (visit 2) after hospital discharge. Results. At visit 1, 60% of patients had restrictive pulmonary ventilation disorders. Obstructive ventilation disorders were detected in only 1 patient. Decreased lung diffusion capacity (D CO corr.) was found in 78% of patients. At visit 2, obstructive disorders were detected in 1 patient, and the frequency of restrictive ventilation disorders was 29%. Decreased DLCO corr. was noted in 57% of cases. The parameters of pulmonary ventilation and pulmonary gas exchange function differed significantly between visits. Significant correlations were found between changes in the functional parameters of the respiratory system and disorders identified at visit 1 after hospital discharge. Conclusion. Thus, there is a decrease in the lung diffusion capacity and the rate of restrictive ventilation disorders even one year after severe COVID-19-associated lung injury. However, our results suggest a marked improvement in respiratory system function over time.
Keywords
Supporting agencies: The study was conducted without the participation of sponsors. The study was carried out as part of the state task “The impact of the new coronavirus infection SARS-CoV-2 on the functional parameters of the respiratory system during recovery” (code: “Post-COVID-functional diagnostics”).
About the Authors
A. V. Chernyak
Federal State Budgetary Institution “Pulmonology Scientific Research Institute” under Federal Medical and Biological Agency of Russian Federation; State Budgetary Healthcare Institution of the City of Moscow “City Clinical Hospital named after D.D.Pletnev of Moscow Department of Health”
Russian Federation
Competing Interests:
Russian Federation
Alexander V. Cherniak, Candidate of Medicine, Head of Laboratory of Functional and Ultra-sound Investigations, Federal State Budgetary Institution “Pulmonology Scientific Research Institute” under Federal Medical and Biological Agency of Russian Federation; Physician of Functional Diagnostics, Department of Functional and Ultrasound Diagnostics, State Budgetary Healthcare Institution of the City of Moscow “City Clinical Hospital named after D.D.Pletnev of Moscow Department of Health”
Author ID: 687383
Orekhovyy bul’var 28, Moscow, 115682; ul. Odinnadtsataya Parkovaya 32, Moscow, 105077
tel.: (495) 395-63-93
Competing Interests:
The authors declare absence of conflicts of interest.
M. Kh. Mustafina
Federal State Budgetary Institution “Pulmonology Scientific Research Institute” under Federal Medical and Biological Agency of Russian Federation;
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, Functional Diagnostics Doctor, Researcher, Laboratory of Functional and Ultrasound Research Methods, Federal State Budgetary Institution “Pulmonology Scientific Research Institute” under Federal Medical and Biological Agency of Russian Federation; Associate Professor, Department of Cardiology, Functional and Ultrasound Diagnostics N.V.Sklifosovsky Institute of Clinical Medicine, 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)
Author ID: 687382
Orekhovyy bul’var 28, Moscow, 115682; ul. Trubetskaya 8, build. 2, Moscow, 119991
tel.: (499) 248-34-77
Competing Interests:
The authors declare absence of conflicts of interest.
Zh. K. Naumenko
Federal State Budgetary Institution “Pulmonology Scientific Research Institute” under Federal Medical and Biological Agency of Russian Federation; State Budgetary Healthcare Institution of the City of Moscow “City Clinical Hospital named after D.D.Pletnev of Moscow Department of Health”
Russian Federation
Competing Interests:
Russian Federation
Zhanna K. Naumenko, Candidate of Medicine, Senior Researcher, Laboratory of Functional and Ultrasound Research Methods, Federal State Budgetary Institution “Pulmonology Scientific Research Institute” under Federal Medical and Biological Agency of Russian Federation; Physician of Functional Diagnostics, Department of Functional and Ultrasound Diagnostics, State Budgetary Healthcare Institution of the City of Moscow “City Clinical Hospital named after D.D.Pletnev of Moscow Department of Health”
Author ID: 687383
Orekhovyy bul’var 28, Moscow, 115682; ul. Odinnadtsataya Parkovaya 32, Moscow, 105077
tel.: (495) 395-63-93
Competing Interests:
The authors declare absence of conflicts of interest.
E. N. Kalmanova
State Budgetary Healthcare Institution of the City of Moscow “City Clinical Hospital named after D.D.Pletnev of Moscow Department of Health”
Russian Federation
Competing Interests:
Russian Federation
Elena N. Kalmanova, Candidate of Medicine, Head of the Department of Functional and Ultrasound Diagnostics
Author ID: 581036
ul. Odinnadtsataya Parkovaya 32, Moscow, 105077
tel.: (495) 965-34-66
Competing Interests:
The authors declare absence of conflicts of interest.
K. A. Zykov
Federal State Budgetary Institution “Pulmonology Scientific Research Institute” under Federal Medical and Biological Agency of Russian Federation;
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, Corresponding Member, Professor 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
Orekhovyy bul’var 28, Moscow, 115682; ul. Delegatskaya 20/1, Moscow, 127473
tel.: (495) 395-63-93
Competing Interests:
The authors declare absence of conflicts of interest.
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For citations:
Chernyak A.V., Mustafina M.Kh., Naumenko Zh.K., Kalmanova E.N., Zykov K.A. Dynamics of functional changes in the respiratory system after COVID-19-associated lung injury at one year after hospital discharge. PULMONOLOGIYA. 2023;33(5):611-621. (In Russ.) https://doi.org/10.18093/0869-0189-2023-33-5-611-621
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