A prospective evaluation of lung function at three and six months in patients with previous SARS-COV-2 pneumonia

Nicla Orzes; Laura Pini; Guido Levi; Silvia Uccelli; Francesca Cettolo; Claudio Tantucci

doi:10.1016/j.rmed.2021.106541

A prospective evaluation of lung function at three and six months in patients with previous SARS-COV-2 pneumonia

Respir Med. 2021 Sep:186:106541. doi: 10.1016/j.rmed.2021.106541. Epub 2021 Jul 10.

Authors

Nicla Orzes¹, Laura Pini², Guido Levi¹, Silvia Uccelli¹, Francesca Cettolo¹, Claudio Tantucci³

Affiliations

¹ Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
² Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy; Respiratory Medicine Unit, Spedali Civili di Brescia, Brescia, Italy. Electronic address: laura.pini@unibs.it.
³ Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy; Respiratory Medicine Unit, Spedali Civili di Brescia, Brescia, Italy.

Abstract

Objective: This study investigated the consequences of Coronavirus Disease 2019 (COVID-19) pneumonia on lung function in the first 6 months after hospital discharge.

Methods: A prospective lung function assessment in SARS-CoV2 patients with COVID-19 pneumonia, hospitalized between March and April 2020, was conducted with spirometry measurements including lung volumes, mainly total lung capacity (TLC), lung diffusion capacity for carbon monoxide (DL_CO) collected at 3 months after hospital discharge. Patients with restrictive ventilatory defect or impaired DL_CO or both were re-evaluated at 6 months with global spirometry and chest HRCT scan.

Results: Among 40 consecutive patients, 19 (48%) had normal pulmonary functional tests (group A), and 21 (52%) showed residual lung function abnormalities at 3 months after hospital discharge (group B). In group B, 4 patients (19%) had only loss of lung volume as shown by TLC reduction (group 1), 13 patients (62%) had decreased both TLC and DL_CO (group 2), and 4 patients (19%) had isolated reduction in DL_CO (group 3). At 6-month follow-up in group 1, although all patients improved, only one normalized total lung capacity (TLC). In group 2, TLC and DL_CO increased significantly (p < 0.01), but only 3 patients reached normal values. In group 3, DL_CO improved for most patients, normalizing in 50% of them. At 6-months significant correlations between an internal-built chest HRCT scan severity score and TLC (r² = 0.33; p < 0.01) and DL_CO (r² = 0.32; p < 0.01) were found.

Conclusions: Nearly 50% of patients recovered in the post-critical phase. Most of those with abnormal pulmonary function tests at 3 months improved subsequently, but only another 29% (6 out of 21) reached normal values at 6 months. These results indicate that lung function spontaneous recovery is faster at first and occurs more slowly thereafter, leaving more than one third (15 out of 40) of patients with abnormal lung function tests at 6 months.

Keywords: COVID-19; Lung function; Pneumonia; SARS-CoV2; Spirometry.

Publication types

Observational Study

MeSH terms

Aged
Biosimilar Pharmaceuticals
Female
Humans
Lung / physiopathology*
Male
Middle Aged
Patient Discharge
Prospective Studies
Recovery of Function
SARS-CoV-2 / pathogenicity*
Severe Acute Respiratory Syndrome / diagnosis*
Severe Acute Respiratory Syndrome / physiopathology*
Severe Acute Respiratory Syndrome / virology
Spirometry*
Time Factors
Total Lung Capacity*

Substances

Biosimilar Pharmaceuticals