Pulmonary function assessment after COVID-19 in vaccinated healthcare workers

Lorenzo Ippoliti; Luca Coppeta; Giuseppina Somma; Giuseppe Bizzarro; Francesco Borelli; Teresa Crispino; Cristiana Ferrari; Ilaria Iannuzzi; Andrea Mazza; Agostino Paolino; Andrea Magrini; Antonio Pietroiusti

doi:10.1186/s12995-023-00400-7

Pulmonary function assessment after COVID-19 in vaccinated healthcare workers

J Occup Med Toxicol. 2023 Dec 15;18(1):31. doi: 10.1186/s12995-023-00400-7.

Affiliations

¹ Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, 00133, Italy. ippoliti.lo@libero.it.
² Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, 00133, Italy.
³ Saint Camillus International University of Health Sciences, Rome, 00131, Italy.

Abstract

COVID-19 typically presents with flu-like symptoms due to the viral infection itself. The most severe cases are characterised by lung damage, an important factor in fatal outcome due to alveolar damage. In some cases, patients develop a long COVID with persistent symptoms of chest pain and fatigue. Causes, including organ damage or inflammation, are being investigated. Clinical outcomes are variable and permanent lung damage is not fully understood, while vaccination is effective against severe infection but its effect on respiratory function in mild cases remains uncertain. This retrospective study aims to analyse changes in lung function in HCWs who had COVID-19 between 2020 and 2022, comparing their spirometric test results before and after the pandemic and taking into account their vaccination status. 321 HCWs were included in the study. The study examined spirometric parameters both before and after the pandemic, and all measured outcomes except the FEV1/FVC ratio showed a significant decrease during the study period. We then assessed the association between SARS-CoV-2 infection and changes in lung function parameters, analysing infections in 2020, 2021 and 2022 separately. We found a statistically significant difference in Forced vital capacity (FVC) between infected and non-infected subjects in 2020 and 2021, but not in 2022. To evaluate the protective effect of SARS-CoV-2 vaccination on respiratory function, a linear regression analysis was performed using changes in FVC, Forced expiratory volume in 1 s (FEV1), FVC/FEV1 ratio and Peak expiratory flow (PEF) as dependent variables. The analysis showed that the decline in FVC was significantly lower in subjects who had been vaccinated prior to infection. The study concludes that subclinical SARS-CoV-2 infections in 2020 and 2021 worsened respiratory parameters (FVC and FEV1), but vaccination protected against these effects. Even healthy individuals with previous infections showed respiratory changes, with vaccination providing protection, especially for FVC decline. This highlights the importance of vaccinating healthcare workers against COVID-19.

Keywords: COVID-19; Healthcare workers; Respiratory function; SARS-CoV-2; Spirometry; Vaccination.