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Munker, D. ; Veit, T. ; Barton, J. ; Mertsch, P. ; Mümmler, C. ; Osterman, A.* ; Khatamzas, E.* ; Barnikel, M. ; Hellmuth, J.C.* ; Münchhoff, M.* ; Walter, J. ; Ghiani, A.* ; Munker, S.* ; Dinkel, J.* ; Behr, J. ; Kneidinger, N. ; Milger, K.

Pulmonary function impairment of asymptomatic and persistently symptomatic patients 4 months after COVID-19 according to disease severity.

Infection, DOI: 10.1007/s15010-021-01669-8 (2021)
Verlagsversion DOI
Open Access Gold (Paid Option)
Creative Commons Lizenzvertrag
Objective: Evaluation of pulmonary function impairment after COVID-19 in persistently symptomatic and asymptomatic patients of all disease severities and characterisation of risk factors. Methods: Patients with confirmed SARS-CoV-2 infection underwent prospective follow-up with pulmonary function testing and blood gas analysis during steady-state cycle exercise 4 months after acute illness. Pulmonary function impairment (PFI) was defined as reduction below 80% predicted of DLCOcSB, TLC, FVC, or FEV1. Clinical data were analyzed to identify risk factors for impaired pulmonary function. Results: 76 patients were included, hereof 35 outpatients with mild disease and 41 patients hospitalized due to COVID-19. Sixteen patients had critical disease requiring mechanical ventilation, 25 patients had moderate–severe disease. After 4 months, 44 patients reported persisting respiratory symptoms. Significant PFI was prevalent in 40 patients (52.6%) occurring among all disease severities. The most common cause for PFI was reduced DLCOcSB (n = 39, 51.3%), followed by reduced TLC and FVC. The severity of PFI was significantly associated with mechanical ventilation (p < 0.001). Further risk factors for DLCO impairment were COPD (p < 0.001), SARS-CoV-2 antibody-Titer (p = 0.014) and in hospitalized patients CT score. A decrease of paO2 > 3 mmHg during cycle exercise occurred in 1/5 of patients after mild disease course. Conclusion: We characterized pulmonary function impairment in asymptomatic and persistently symptomatic patients of different severity groups of COVID-19 and identified further risk factors associated with persistently decreased pulmonary function. Remarkably, gas exchange abnormalities were revealed upon cycle exercise in some patients with mild disease courses and no preexisting pulmonary condition.
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Publikationstyp Artikel: Journalartikel
Dokumenttyp Wissenschaftlicher Artikel
Schlagwörter Covid-19 ; Post-covid ; Pulmonary Function Impairment ; Sars-cov-2; Clinical Characteristics; Discharge; Wuhan; China; Ct
ISSN (print) / ISBN 0300-8126
e-ISSN 1439-0973
Verlag Urban & Vogel
Verlagsort Tiergartenstrasse 17, D-69121 Heidelberg, Germany
Begutachtungsstatus Peer reviewed
Förderungen Projekt DEAL