More complaints than findings - Long-term pulmonary function in children and adolescents after COVID-19

Background: The frequency of persistent symptoms after coronavirus disease 2019 (COVID-19) in adults varies from 4.5% to 87%. Pulmonary function can also show long-term impairment in adults: 10% of hospitalised adults had reduced spirometry values, and 24% had decreased diffusion capacity. To date, only preliminary evidence is available on persistent respiratory sequelae in children and adolescents, therefore our objective was to examine the long-term effects of COVID-19 on pulmonary function in this age group. Methods: Multiple-breath washout, body plethysmography, and diffusion capacity testing were performed after an average of 2.6 months (range 0.4-6.0) following COVID-19 in 73 children and adolescents (age 5-18 years) with different disease severity. Cases were compared to 45 controls with and without infection within six months prior to assessment after exclusion of severe acute respiratory coronavirus-2 infection (SARS-CoV-2). Results: Of the 19 patients (27.1%) who complained about persistent or newly emerged symptoms since COVID-19, 8 (11.4%) reported respiratory symptoms. Comparing patients with COVID-19 to controls, no significant differences were detected in frequency of abnormal pulmonary function (COVID-19: 12, 16.4%; controls: 12, 27.7%; OR 0.54, 95% CI 0.22-1.34). Only two patients with persistent respiratory symptoms showed abnormal pulmonary function. Multivariate analysis revealed reduced forced vital capacity (p=0.045) in patients with severe infection regardless of SARS-CoV-2 infection. Discussion: Pulmonary function is rarely impaired in children and adolescents after COVID-19, except of those with severe infection. The discrepancy between persistent respiratory symptoms and normal pulmonary function suggests a different underlying pathology such as dysfunctional breathing.

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Long-Term Effects of Welding Fumes upon Respiratory Symptoms and Pulmonary Function

Journal of Occupational and Environmental Medicine ◽

10.1097/00043764-198005000-00007 ◽

1980 ◽

Vol 22 (5) ◽

pp. 337-341 ◽

Cited By ~ 28

Author(s):

Farhang Akbarkhanzadeh

Keyword(s):

Pulmonary Function ◽

Respiratory Symptoms ◽

Welding Fumes ◽

Long Term Effects

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LONG-TERM EFFECTS OF SOLDERING FUMES UPON RESPIRATORY SYMPTOMS AND PULMONARY FUNCTION

The Annals of Occupational Hygiene ◽

10.1093/annhyg/35.3.299 ◽

1991 ◽

Cited By ~ 1

Keyword(s):

Pulmonary Function ◽

Respiratory Symptoms ◽

Long Term Effects

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Coronavirus Pneumonia: Outcomes and Characteristics of Patients in an Inner-City Area after 3 Months of Infection

Journal of Clinical Medicine ◽

10.3390/jcm10153368 ◽

2021 ◽

Vol 10 (15) ◽

pp. 3368

Author(s):

Gilda Diaz-Fuentes ◽

Gabriella Roa-Gomez ◽

Olga Reyes ◽

Ravish Singhal ◽

Sindhaghatta Venkatram

Keyword(s):

New York ◽

Pulmonary Function ◽

Severe Infection ◽

Airway Disease ◽

Abnormal Finding ◽

Diffusion Capacity ◽

The Common ◽

Work Up ◽

Initial Peak

Background: The morbidity and long term pulmonary consequences of COVID-19 infection continue to unfold as we learn and follow survivors of this disease. We report radiological evolution and pulmonary function findings in those patients. Methods: This was a retrospective cohort study of adult patients referred to the post-acute COVID-19 pulmonary clinic after a diagnosis of COVID-19 pneumonia. The study period was after the initial peak of the pandemic in New York City, from June to December 2020. Results: 111 patients were included. The average interval time between COVID-19 pneumonia and initial clinic evaluation was 12 weeks. 48.2% of patients had moderate and 22.3% had severe infection. Dyspnea and cough was the most common respiratory symptoms post infection. Radiographic abnormalities improved in majority of patients with ground glass opacities been the common residual abnormal finding. Restrictive airway disease and decreased diffusion capacity were the most common findings in pulmonary function test. Conclusion: Our study suggests the needs for close and serial monitoring of functional and radiological abnormalities during the post COVID-19 period. Considering that many of the clinical-radiological and functional abnormalities are reversible, we suggest a “wait and watch“approach to avoid unnecessary invasive work up.

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Vitamin E intake, α-tocopherol levels and pulmonary function in children and adolescents with cystic fibrosis

British Journal Of Nutrition ◽

10.1017/s0007114515000215 ◽

2015 ◽

Vol 113 (7) ◽

pp. 1096-1101 ◽

Cited By ~ 6

Author(s):

Janna W. Woestenenk ◽

Nancy Broos ◽

Rebecca K. Stellato ◽

Hubertus G. M. Arets ◽

Cornelis K. van der Ent ◽

...

Keyword(s):

Cystic Fibrosis ◽

Vitamin E ◽

Pulmonary Function ◽

Children And Adolescents ◽

Real Life ◽

Protective Effects ◽

Long Term Effects ◽

Therapeutic Benefits ◽

Serum Igg

Pancreatic insufficiency cystic fibrosis (CF) patients receive vitamin E supplementation according to CF-specific recommendations in order to prevent deficiencies. It has been suggested that higher serum α-tocopherol levels could have protective effects on pulmonary function (PF) in patients with CF. Whether current recommendations are indeed optimal for preventing deficiency and whether vitamin E has therapeutic benefits are subjects of debate. Therefore, we studied vitamin E intake as well as the long-term effects of vitamin E intake, the coefficient of fat absorption (CFA) and IgG on α-tocopherol levels. We also examined the long-term effects of serum α-tocopherol and serum IgG on forced expiratory volume in 1 s expressed as percentage of predicted (FEV1% pred.) in paediatric CF patients during a 7-year follow-up period. We found that CF patients failed to meet the CF-specific vitamin E recommendations, but serum α-tocopherol below the 2·5th percentile was found in only twenty-three of the 1022 measurements (2 %). Furthermore, no clear effect of vitamin E intake or the CFA on serum α-tocopherol was found (both P≥ 0·103). FEV1% pred. was longitudinally inversely associated with age (P< 0·001) and serum IgG (P= 0·003), but it was not related to serum α-tocopherol levels. We concluded that in the present large sample of children and adolescents with CF, vitamin E intake was lower than recommended, but serum α-tocopherol deficiency was rare. We found no evidence that higher serum α-tocopherol levels had protective effects on PF. Adjustment of the recommendations to the real-life intake of these patients may be considered.

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Concussion in sports in children and adolescents – to play or not to play?

Swiss Sports & Exercise Medicine ◽

10.34045/ssem/2017/18 ◽

2017 ◽

Vol 65 (3) ◽

Keyword(s):

Gender Differences ◽

Children And Adolescents ◽

Return To Sport ◽

Consensus Conference ◽

Return To School ◽

The Novel ◽

International Consensus ◽

Persistent Symptoms ◽

New Findings

A lot has been published on the topic concussion in sports during the last years, conscience was sharpened, much was structured and defined more precisely, help tools were developed and rules changed. This article summarizes the fifth edition of the recently published guidelines of the “International Consensus Conference on Concussion in Sport”. In addition, new findings regarding gender differences and recovery will be presented, as well as the modified “return-to-sport” and the novel “return-to-school” protocols. Despite increased knowledge many questions remain such as the therapy of persistent symptoms or long-term sequelae of recurrent concussions.

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Long COVID—The New “Invisible” Illness: How School Nurses Can Support the Nursing and Educational Teams for Student Success

NASN School Nurse ◽

10.1177/1942602x211059427 ◽

2021 ◽

pp. 1942602X2110594

Author(s):

Megan Roesler ◽

Patricia Fato ◽

Barbara Obst

Keyword(s):

School Nurses ◽

School Age Children ◽

Return To School ◽

School Age ◽

Long Term Effects ◽

Persistent Symptoms ◽

School Based ◽

School Based Interventions ◽

The Waves

School-age children are not immune to COVID-19 or the pronounced and persistent symptoms associated with a long-COVID diagnosis. Students may present with a variety of symptoms affecting their physical, cognitive, and mental health. The school community should be educated on the school-based interventions and recommendations for creating an individualized safe and successful return to school plan. As we await approval for vaccinations in school-age children younger than 12 years and continue to reposition ourselves to the waves of this pandemic and new variants of the virus, understanding the medical and educational long-term effects on our students may be a long-term need.

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Short- and long-term effects of diving on pulmonary function

European Respiratory Review ◽

10.1183/16000617.0097-2016 ◽

2017 ◽

Vol 26 (143) ◽

pp. 160097 ◽

Cited By ~ 8

Author(s):

Kay Tetzlaff ◽

Paul S. Thomas

Keyword(s):

Lung Function ◽

Pulmonary Function ◽

Ambient Pressure ◽

Small Airways ◽

Long Term Effects ◽

Cold Temperatures ◽

Factors Associated ◽

Stress Changes ◽

The Impact

The diving environment provides a challenge to the lung, including exposure to high ambient pressure, altered gas characteristics and cardiovascular effects on the pulmonary circulation. Several factors associated with diving affect pulmonary function acutely and can potentially cause prolonged effects that may accumulate gradually with repeated diving exposure. Evidence from experimental deep dives and longitudinal studies suggests long-term adverse effects of diving on the lungs in commercial deep divers, such as the development of small airways disease and accelerated loss of lung function. In addition, there is an accumulating body of evidence that diving with self-contained underwater breathing apparatus (scuba) may not be associated with deleterious effects on pulmonary function. Although changes in pulmonary function after single scuba dives have been found to be associated with immersion, ambient cold temperatures and decompression stress, changes in lung function were small and suggest a low likelihood of clinical significance. Recent evidence points to no accelerated loss of lung function in military or recreational scuba divers over time. Thus, the impact of diving on pulmonary function largely depends on factors associated with the individual diving exposure. However, in susceptible subjects clinically relevant worsening of lung function may occur even after single shallow-water scuba dives.

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