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- Title
Gas Exchange Impairment During COVID-19 Recovery.
- Authors
Gochicoa-Rangel, Laura; Hernández-Morales, Aloisia Paloma; Salles-Rojas, Antonio; Madrid-Mejía, Wilmer; Guzmán-Valderrábano, Carlos; González-Molina, Amaury; Salas-Escamilla, Isabel; Durán-Cuellar, Adela; Silva-Cerón, Mónica; Hernández-Morales, Víctor; Reyes-García, Alejandro; Alvarado-Amador, Irlanda; Lozano-Martínez, Luis; Enright, Paul; Pensado-Piedra, Lya Edith; Torre-Bouscoulet, Luis
- Abstract
BACKGROUND: Persistent impairment of pulmonary function and exercise capacity has been known to last for months or even years in the survivors who recovered from other coronavirus pneumonia. Some reports showed that subjects with coronavirus disease 2019 pneumonia after being discharged could have several sequelae, but there are few studies on gas exchange and exercise capacity complications in these subjects. AIMS: To describe residual gas exchange abnormalities during recovery from coronavirus disease 2019 pneumonia. METHODS: In an observational study, ~90 d after onset of disease, we scheduled almost 200 subjects for an outpatient visit with pulmonary function testing and computed tomography of the lungs. Lung mechanics by using body plethysmography, gas exchange with diffusing lung capacity for carbon monoxide determined by the single-breath technique (DLCOsb) and diffusing lung capacity for nitric oxide determined by the single-breath technique (DLNOsb), and exercise ability by using the 6-min walk test (6MWT) were measured in the subjects. The results were compared between those who required invasive mechanical ventilation and those who did not. RESULTS: A total of 171 subjects were included, the majority (96%) had signs of residual pneumonia (such as an excess of high attenuation areas) on computed tomography of the lungs. The DLCOSB results were below the lower limit of the normal range in 29.2% of the subjects; during the 6MWT, 67% experienced oxygen desaturation (SpO2) > 4%; and, in 81 (47%), the dropped below 88%. Subjects who required invasive mechanical ventilation (49.7%) were more likely to have lower lung volumes, more gas exchange abnormality, less exercise capacity and more radiologic abnormality. CONCLUSIONS: Subjects who recovered from severe COVID-19 pneumonia continued to have abnormal lung function and abnormal radiologic findings.
- Subjects
RESPIRATORY organ anatomy; LUNG radiography; MEDICAL rehabilitation; X-rays; PLETHYSMOGRAPHY; STATISTICS; COVID-19; SCIENTIFIC observation; CARBON monoxide; LUNG diseases; OXYGEN saturation; MANN Whitney U Test; ARTIFICIAL respiration; T-test (Statistics); PULMONARY function tests; EXERCISE; DESCRIPTIVE statistics; CHI-squared test; COMPUTED tomography; NITRIC oxide; SPIROMETRY; PULSE oximeters; DATA analysis software; STATISTICAL correlation; DATA analysis; PULMONARY gas exchange
- Publication
Respiratory Care, 2021, Vol 66, Issue 10, p1610
- ISSN
0020-1324
- Publication type
Article
- DOI
10.4187/respcare.09114