Comprehensive evaluation of the respiratory system, cardiovascular system, and psychoemotional disorders in post-COVID-19 adult patients
https://doi.org/10.18093/0869-0189-2024-4500
Abstract
The aim was to study changes in the respiratory system, cardiovascular system, functional and psychoemotional status of adult patients after inpatient treatment for COVID-19 (COronaVIrus Disease 2019). Methods. This cohort prospective observational study recruited patients with COVID-19 and lung damage. Transthoracic echocardiography, lung ultrasound, ECG, dyspnea assessment using mMRC and Borg scales, 6-minute walk test, and pulmonary function tests were performed 3 months after discharge from hospital. Psychoemotional status was assessed using MFI-20 international asthenia test, Spielberger–Hanin situational anxiety scale, Beck depression scale, MMSE cognitive function assessment scale. A standard set of statistical tools was used to describe and compare the data. The differences were considered statistically significant at p < 0.05. Results. A total of 51 patients were enrolled, including 29 (55.8%) women, the median age 64.5 (60.0 – 70.0) years. The most frequent complaints at 3 months after the hospital discharge were weakness (88.2%) and mild (62.7%) to moderate (29.4%) dyspnea. There was a decrease in the lung tissue lesions compared to inpatient treatment (14.5 vs 23.0 points), but the lung ultrasound found consolidates in 78.4% of the patients. The degree of lung tissue lesions correlated with the functional status of the patients. Decreased diffusion lung capacity (DLCO) was the most frequent functional disorder. It was detected in 23.1% of the patients and accompanied by decreased 6-minute walk test distance and increased volume of lung lesions according to the ultrasound. The threshold value of ultrasound score indicative of the abnormal lung diffusion capacity was 24.5 at the stage of inpatient treatment and 15.5 points at 3 months after discharge from hospital. A mental status assessment at 3 months after discharge from hospital showed that asthenia persisted in all patients. Their anxiety and depression statistically significantly decreased, and the cognitive status improved. Conclusion. The majority of adult patients who had COVID-19 with lung damage still have complaints, lung tissue changes of varying severity at 3 months after discharge from hospital. A significant proportion of the patients also had psychoemotional disorders, abnormalities in the performance of functional tests, and impaired DLCO. Lung ultrasound can be considered an informative non-invasive method of assessing severity of the lung tissue damage, allowing to predict impaired gas transport function of the lungs.
About the Authors
Kh. S. DelmaevaRussian Federation
Kheda S. Delmaeva, Physician of the Internal Medicine Unit
Kolomenskiy pr. 4, Moscow, 115446;
tel.: (926) 885-42-41
Competing Interests:
The authors did not declare any conflicts of interests.
N. V. Mukhina
Russian Federation
Nadezhda V. Mukhina, Candidate of Medicine, Associate Professor of the Department of Hospital Therapy No.2, N.V.Sklifosovsky Institute of Clinical Medicine
ul. Trubetskaya 8, build. 2, Moscow, 119991;
tel.: (916) 643-25-91
Competing Interests:
The authors did not declare any conflicts of interests.
I. S. Komarova
Russian Federation
Irina S. Komarova, Candidate of Medicine, Associate Professor of the Department of Hospital Therapy No.2, N.V.Sklifosovsky Institute of Clinical Medicine
ul. Trubetskaya 8, build. 2, Moscow, 119991;
tel.: (926) 113-43-41
Competing Interests:
The authors did not declare any conflicts of interests.
G. V. Nekludova
Russian Federation
Galina V. Nekludova, Doctor of Medicine, Professor, Professor of the Department of Pulmonology, N.V.Sklifosovsky Institute of Clinical Medicine
ul. Trubetskaya 8, build. 2, Moscow, 119991;
tel.: (916) 296-01-64
Competing Interests:
The authors did not declare any conflicts of interests.
A. A. Metalnickov
Russian Federation
Artem A. Metalnickov, Physician-methodologist, Department of analysis of Educational Programs and Scientific Research, National Medical Research Center for the profile “Pulmonology”
ul. Trubetskaya 8, build. 2, Moscow, 119991;
tel.: (910) 907-53-74
Competing Interests:
The authors did not declare any conflicts of interests.
S. N. Avdeev
Russian Federation
Sergey N. Avdeev, Doctor of Medicine, Professor, Academician of Russian Academy of Sciences, Head of the Department of Pulmonology, N.V.Sklifosovsky Institute of Clinical Medicine; Chief Freelance Pulmonologist of the Ministry of Health of the Russian Federation; Director of the National Medical Research Center for Pulmonology
ul. Trubetskaya 8, build. 2, Moscow, 119991;
tel.: (499) 246-75-18
Competing Interests:
The authors did not declare any conflicts of interests.
S. A. Rachina
Russian Federation
Svetlana A. Rachina, Doctor of Medicine, Professor, Head of the Department of Hospital Therapy No.2, N.V.Sklifosovsky Institute of Clinical Medicine
ul. Trubetskaya 8, build. 2, Moscow, 119991;
tel.: (910) 715-89-55
Competing Interests:
The authors did not declare any conflicts of interests.
A. A. Sokolov
Russian Federation
Alexander A. Sokolov, Head of the Ultrasound Diagnostics Department
Kolomenskiy pr. 4, Moscow, 115446;
tel.: (906) 768-38-78
Competing Interests:
The authors did not declare any conflicts of interests.
N. A. Ananicheva
Russian Federation
Natalia A. Ananicheva, Head of the Regional Vascular Center, Chief District Cardiologist of the Southern Administrative District, Moscow
Kolomenskiy pr. 4, Moscow, 115446;
tel.: (916) 912-99-69
Competing Interests:
The authors did not declare any conflicts of interests.
S. S. Mirzakhamidova
Russian Federation
Svetlana S. Mirzakhamidova, Candidate of Medicine, Deputy Chief Physician for Medical Work
Kolomenskiy pr. 4, Moscow, 115446;
tel.: (916) 206-33-08
Competing Interests:
The authors did not declare any conflicts of interests.
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Supplementary files
Review
For citations:
Delmaeva Kh.S., Mukhina N.V., Komarova I.S., Nekludova G.V., Metalnickov A.A., Avdeev S.N., Rachina S.A., Sokolov A.A., Ananicheva N.A., Mirzakhamidova S.S. Comprehensive evaluation of the respiratory system, cardiovascular system, and psychoemotional disorders in post-COVID-19 adult patients. PULMONOLOGIYA. 2025;35(1):49-60. (In Russ.) https://doi.org/10.18093/0869-0189-2024-4500