The acute impact of a hematopoietic allograft on lung function and inflammation: a prospective observational study

Abstract Background:The clinical course of coronavirus disease 2019 (COVID-19) varies distinctly. Particularly after severe or critical courses, i.e., after hospitalization, clinical manifestations frequently persist after the acute phase. However, symptoms may also persist after initially milder courses that can be treated in an outpatient setting. For patients who remain symptomatic after COVID-19, pulmonary rehabilitation (PR) is recommended. However, only few studies investigated the effectiveness of PR, especially considering different disease courses. The main objective was to evaluate the feasibility, safety, and efficacy of post-COVID-19 PR.Methods:A total of 120 post-COVID-19 patients who were referred to the Bad Reichenhall Clinic between April 2020 and January 2021 were asked to participate in this prospective observational study. PR was tailored to each patient’s individual needs and was based on the current recommendations. The primary outcome dyspnea was assessed with numerical rating scales and the modified Medical Research Council (mMRC) dyspnea scale. Secondary outcomes included other symptoms such as cough and sputum; physical capacity; lung function; fatigue; quality of life (QoL); depression; and anxiety. Furthermore, patients rated the overall effectiveness of PR and their subjective change in health status.Results:A total of 108 patients (mean age 55.6±10.1 years, 45.4% female) were included and were assigned to 3 groups depending on the referral mode (A: severe acute; B: severe after interval, C: mild after interval). At the end of PR, we detected improvements in the intensity of exertional dyspnea, physical capacity, QoL, fatigue, and depression in the overall group, with large effect sizes (Cohen’s d>0.8). Moderate effect sizes (0.5≤d<0.8) were found for resting dyspnea and the mMRC-dyspnea scale. Cohen’s d>0.4 was found for vital capacity, forced expiratory volume in one second, partial oxygen pressure, and anxiety. Significant but rather small effect sizes (0.2<d<0.4) were found for cough, sputum, pain, and other lung function parameters.Conclusions:PR is feasible, safe, and effective after acute COVID-19, which was true for all 3 groups analyzed, with a trend toward greater efficacy after severe courses of COVID-19 and an earlier start of PR after acute COVID-19. Therefore, all post-COVID-19 patients who remain symptomatic should be offered PR.Trial registration: German Clinical Trials Register, DRKS00023180. Registered 01 September 2020 – Retrospectively registered, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00023180

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Clinical, radiological and functional outcomes in patients with SARS-CoV-2 pneumonia: a prospective observational study

BMC Pulmonary Medicine ◽

10.1186/s12890-021-01509-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Pietro Gianella ◽

Elia Rigamonti ◽

Marco Marando ◽

Adriana Tamburello ◽

Lorenzo Grazioli Gauthier ◽

...

Keyword(s):

Quality Of Life ◽

Lung Function ◽

Observational Study ◽

Ct Scan ◽

Prospective Observational Study ◽

Lung Function Tests ◽

Medium Term ◽

Function Tests

Abstract Background All over the world, SARS-CoV-2 pneumonia is causing a significant short-term morbidity and mortality, but the medium-term impact on lung function and quality of life of affected patients are still unknown. Methods In this prospective observational study, 39 patients with SARS-CoV-2 pneumonia were recruited from a single COVID-19 hospital in Southern Switzerland. At three months patients underwent radiological and functional follow-up through CT scan, lung function tests, and 6 min walking test. Furthermore, quality of life was assessed through self-reported questionnaires. Results Among 39 patients with SARS-CoV-2 pneumonia, 32 (82% of all participants) presented abnormalities in CT scan and 25 (64.1%) had lung function tests impairment at three months. Moreover, 31 patients (79.5%) reported a perception of poor health due to respiratory symptoms and all 39 patients showed an overall decreased quality of life. Conclusions Medium-term follow up at three months of patients diagnosed with SARS-CoV-2 pneumonia shows the persistence of abnormalities in CT scans, a significant functional impairment assessed by lung function tests and a decreased quality of life in affected patients. Further studies evaluating the long-term impact are warranted to guarantee an appropriate follow-up to patients recovering from SARS-CoV-2 pneumonia.

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The relationship between respiratory system impedance and lung function in asthmatics: A prospective observational study

Respiratory Physiology & Neurobiology ◽

10.1016/j.resp.2017.01.016 ◽

2017 ◽

Vol 239 ◽

pp. 41-45 ◽

Cited By ~ 3

Author(s):

Takahiro Kamada ◽

Masahiro Kaneko ◽

Hiromi Tomioka

Keyword(s):

Lung Function ◽

Observational Study ◽

Respiratory System ◽

Prospective Observational Study ◽

The Relationship

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Investigation of prognostic factors for skin sclerosis and lung function in Japanese patients with early systemic sclerosis: a multicentre prospective observational study

Rheumatology ◽

10.1093/rheumatology/ker333 ◽

2011 ◽

Vol 51 (1) ◽

pp. 129-133 ◽

Cited By ~ 10

Author(s):

M. Hasegawa ◽

Y. Asano ◽

H. Endo ◽

M. Fujimoto ◽

D. Goto ◽

...

Keyword(s):

Prognostic Factors ◽

Systemic Sclerosis ◽

Lung Function ◽

Observational Study ◽

Prospective Observational Study ◽

Japanese Patients ◽

Skin Sclerosis ◽

Early Systemic Sclerosis

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Predictors of Prolonged Cardiopulmonary Exercise Impairment After COVID-19 Infection: A Prospective Observational Study

Frontiers in Medicine ◽

10.3389/fmed.2021.773788 ◽

2021 ◽

Vol 8 ◽

Author(s):

Karin Vonbank ◽

Antje Lehmann ◽

Dominik Bernitzky ◽

Maximilian Robert Gysan ◽

Stefan Simon ◽

...

Keyword(s):

Lung Function ◽

Observational Study ◽

Exercise Performance ◽

Prospective Observational Study ◽

Cardiopulmonary Exercise Testing ◽

Peak Oxygen Uptake ◽

Submaximal Exercise ◽

Control Group ◽

Skeletal Muscle Function ◽

Cardiopulmonary Exercise

Objectives: Coronavirus disease 2019 (COVID-19) is a global pandemic affecting individuals to varying degrees. There is emerging evidence that even patients with mild symptoms will suffer from prolonged physical impairment.Methods: In this prospective observational study, lung function, and cardiopulmonary exercise testing have been performed in 100 patients for 3–6 months after COVID-19 diagnosis (post-CoVG). Depending on the severity of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection, patients were divided into asymptomatic, or mild to moderate (mild post-CoVG), and severe post-CoVG [hospitalization with or without intensive care unit/non-invasive ventilation (ICU/NIV)]. Results have been compared with age, sex, and body mass index (BMI) matched control group (CG, N = 50).Results: Both lung function (resting) and exercise capacity (peak workload, Wpeak and peak oxygen uptake, VO2 peak - % predicted) were considerably affected in patients with severe post-CoV (81.7 ± 27.6 and 86.1 ± 20.6%), compared to the mild post-CoVG (104.8 ± 24.0%, p = 0.001 and 100.4 ± 24.8; p = 0.003). In addition, also the submaximal exercise performance was significantly reduced in the severe post-CoVG (predicted VT1/VO2 peak; p = 0.013 and VT2/VO2 peak; p = 0.001). Multiple linear regression analyses revealed that 74 % (adjusted R2) of the variance in relative VO2 peak of patients who had CoV could be explained by the following variables: lower age, male sex, lower BMI, higher DLCO, higher predicted heart rate (HR) peak, lower breathing reserve (BR), and lower SaO2 peak, which were related to higher relative VO2 peak values. Higher NT-proBNP and lower creatinine kinase (CK) values were seen in severe cases compared to patients who experienced mild CoV.Discussion: Maximal and submaximal exercise performance in patients recovering from severe COVID-19 remain negatively affected for 3–6 months after COVID-19 diagnosis. The presented findings reveal that impaired pulmonary, cardiac, and skeletal muscle function contributed to the limitation of VO2 peak in those patients, which may have important implications on rehabilitation programs.

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