The role of breathing biomechanics and diffusing lung capacity in post-COVID dyspnoea formation


DOI: https://dx.doi.org/10.18565/therapy.2024.6.23-35

Melekhov A.V., Svetlakov V.I., Nikitin I.G.

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, Moscow
Abstract. Mechanism of post-COVID symptoms formation is not fully studied yet. Studies comparing the condition of ventilation function (VFL) and diffusing lung capacity (DLC) with the severity of dyspnoea in the long term after COVID-19 have had conflicting results.
The aim: to compare the functional parameters of breathing with the severity of dyspnoea in the post-Covid period, with the initial characteristics of patients and indicators of the severity of coronavirus pneumonia clinical course.
Material and methods. In 3–12 months passed after coronavirus pneumonia of varying severity, 109 patients underwent spirometry, body plethysmography and DLC examinations. The severity of dyspnea was assessed using a 10-point scale and the MRC scale. Data on acute period of COVID- 19’ indexes and comorbidities were collected from medical documentation.
Results. Complaints of dyspnoea of any range of severity were made by 88% of the examined individuals, 94% of them were females and 81% males (p = 0.043). The severity of dyspnoea turned out to be less, and indexes of VFL and DLC were higher in patients with a comparable volume of pulmonary damage in the acute period of COVID-19 with a longer follow-up period, and with a comparable period – with a smaller volume of lung damage. 16% of participants had restrictive VFL disorders, 20% had obstructive ones. Presence of obstructive disorders was associated with older age and a smaller volume of pulmonary damage, and restrictive disorders were associated with a larger volume of lung tissue damage, a higher incidence of coronary heart disease, atherosclerosis and diabetes mellitus, and with a greater severity of dyspnoea. When excluding patients with comorbidities, obstructive and restrictive disorders, Kaplan – Meier analysis demonstrates the association of the probability of dyspnea in the post-COVID period with volumetric and velocity parameters of VFL, as well as with DLCO/VA (diffusing capacity of the lungs for carbon monoxide / alveolar volume), which may indicate at the direct negative impact of SARS-CoV-2 on the alveolar-capillary membrane.
Conclusion. The presence and severity of dyspnoea in the post-COVID period are associated with lower rates of VFL and DLC for any volume of lung damage and at any follow-up period.
Keywords: pulmonary ventilation function, body plethysmography, post-covid syndrome, coronavirus pneumonia, dyspnoea, COVID-19, lung diffusion capacity
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About the Autors

Alexander V. Melekhov, MD, Dr. Sci. (Medicine), professor of the Department of hospital therapy named after G.I. Storozhakov of the Faculty of general medicine, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityanova St.
E-mail: melekhov.aleksandr@yandex.ru
ORCID: https://orcid.org/0000-0002-1637-2402
Vyacheslav I. Svetlakov, MD, assistant at the Department of hospital therapy named after G.I. Storozhakov of the Faculty of general medicine, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityanova St.
E-mail: megadoc@mail.ru
ORCID: https://orcid.org/0000-0001-8654-4030
Igor G. Nikitin, MD, Dr. Sci. (Medicine), professor, head of the Department of hospital therapy named after G.I. Storozhakov of the Faculty of general medicine, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityanova St.
E-mail: igor.nikitin.64@mail.ru
ORCID: https://orcid.org/0000-0003-1699-0881


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