4.5 Article

Evolution and long-term respiratory sequelae after severe COVID-19 pneumonia: nitric oxide diffusion measurement value

Journal

RESPIRATORY RESEARCH
Volume 24, Issue 1, Pages -

Publisher

BMC
DOI: 10.1186/s12931-023-02344-2

Keywords

COVID-19; Pneumonia; Sequelae; Respiratory function tests; Diffusion capacity; DLCO; DLNO; Long-term sequelae

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This study is the first to assess the lung diffusing capacity in patients with COVID-19 pneumonia 12 months after discharge. The study found improvements in exercise tolerance, extent of ground-glass opacity, and lung function test results between 3 and 12 months after discharge, but no decrease in dyspnea or self-perceived health condition. DLNO was the most significantly altered parameter at 12 months, with improvement mainly observed in alveolar units and their vascular component.
IntroductionThere are no published studies assessing the evolution of combined determination of the lung diffusing capacity for both nitric oxide and carbon monoxide (DLNO and DLCO) 12 months after the discharge of patients with COVID-19 pneumonia.MethodsProspective cohort study which included patients who were assessed both 3 and 12 months after an episode of SARS-CoV-2 pneumonia. Their clinical status, health condition, lung function testings (LFTs) results (spirometry, DLNO-DLCO analysis, and six-minute walk test), and chest X-ray/computed tomography scan images were compared.Results194 patients, age 62 years (P25-75, 51.5-71), 59% men, completed the study. 17% required admission to the intensive care unit. An improvement in the patients' exercise tolerance, the extent of the areas of ground-glass opacity, and the LFTs between 3 and 12 months following their hospital discharge were found, but without a decrease in their degree of dyspnea or their self-perceived health condition. DLNO was the most significantly altered parameter at 12 months (19.3%). The improvement in DLNO-DLCO mainly occurred at the expense of the recovery of alveolar units and their vascular component, with the membrane factor only improving in patients with more severe infections.ConclusionsThe combined measurement of DLNO-DLCO is the most sensitive LFT for the detection of the long-term sequelae of COVID-19 pneumonia and it explain better their pathophysiology.

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