Pulmonary function and functional capacity in COVID-19 survivors with persistent dyspnoea

Arturo Cortés-Telles; Stephanie López-Romero; Esperanza Figueroa-Hurtado; Yuri Noemi Pou-Aguilar; Alyson W Wong; Kathryn M Milne; Christopher J Ryerson; Jordan A Guenette

doi:10.1016/j.resp.2021.103644

Pulmonary function and functional capacity in COVID-19 survivors with persistent dyspnoea

Respir Physiol Neurobiol. 2021 Jun:288:103644. doi: 10.1016/j.resp.2021.103644. Epub 2021 Feb 27.

Authors

Arturo Cortés-Telles¹, Stephanie López-Romero², Esperanza Figueroa-Hurtado³, Yuri Noemi Pou-Aguilar³, Alyson W Wong⁴, Kathryn M Milne⁴, Christopher J Ryerson⁴, Jordan A Guenette⁵

Affiliations

¹ Respiratory and Thoracic Surgery Unit. Hospital Regional de Alta Especialidad de la Peninsula de Yucatan, Calle 7 por 20 y 22 Num. 433, Fraccionamiento Altabrisa, Mérida, Yucatán, 97130, Mexico. Electronic address: dr_morenheim@hotmail.com.
² Internal Medicine Department. Hospital Regional de Alta Especialidad de la Peninsula de Yucatan, Calle 7 por 20 y 22 Num. 433, Fraccionamiento Altabrisa, Mérida, Yucatán, 97130, Mexico.
³ Respiratory and Thoracic Surgery Unit. Hospital Regional de Alta Especialidad de la Peninsula de Yucatan, Calle 7 por 20 y 22 Num. 433, Fraccionamiento Altabrisa, Mérida, Yucatán, 97130, Mexico.
⁴ Department of Medicine, The University of British Columbia, 2775 Laurel Street, Vancouver, British Columbia, V5Z 1M9, Canada; Centre for Heart Lung Innovation, Providence Health Care Research Institute, The University of British Columbia and St. Paul's Hospital, 166-1081 Burrard Street, Vancouver, British Columbia, V6Z 1Y6, Canada.
⁵ Centre for Heart Lung Innovation, Providence Health Care Research Institute, The University of British Columbia and St. Paul's Hospital, 166-1081 Burrard Street, Vancouver, British Columbia, V6Z 1Y6, Canada; Department of Physical Therapy, The University of British Columbia, 2177 Wesbrook Mall, Vancouver, British Columbia, V6T 1Z3, Canada.

Abstract

The purpose of this study was to examine the physiological mechanisms of persistent dyspnoea in COVID-19 survivors. Non-critical patients (n = 186) with varying degrees of COVID-19 severity reported persistent symptoms using a standardized questionnaire and underwent pulmonary function and 6-minute walk testing between 30 and 90 days following the onset of acute COVID-19 symptoms. Patients were divided into those with (n = 70) and without (n = 116) persistent dyspnoea. Patients with persistent dyspnoea had significantly lower FVC (p = 0.03), FEV₁ (p = 0.04), D_LCO (p = 0.01), 6-minute walk distance (% predicted, p = 0.03), and end-exercise oxygen saturation (p < 0.001), and higher Borg 0-10 ratings of dyspnoea and fatigue (both p < 0.001) compared to patients without persistent dyspnoea. We have shown that dyspnoea is a common persistent symptom across varying degrees of initial COVID-19 severity. Patients with persistent dyspnoea had greater restriction on spirometry, lower D_LCO, reduced functional capacity, and increased exertional desaturation and symptoms. This suggests that there is a true physiological mechanism that may explain persistent dyspnoea after COVID-19.

Keywords: 6-Minute walk test; Breathlessness; Persistent symptoms; SARS-CoV-2.

MeSH terms

Adult
Aged
COVID-19 / complications*
COVID-19 / physiopathology
Chronic Disease
Dyspnea / blood
Dyspnea / physiopathology*
Exercise Tolerance*
Fatigue / physiopathology*
Female
Forced Expiratory Volume
Functional Status
Humans
Male
Middle Aged
Oxygen / blood
Post-Acute COVID-19 Syndrome
Pulmonary Gas Exchange*
Respiratory Function Tests
SARS-CoV-2
Severity of Illness Index
Spirometry*
Survivors
Vital Capacity
Walk Test

Substances

Oxygen