Association Between the Degree of Lung Tissue Damage and Functional Capacity in Patients After COVID-19 Pneumonia
DOI:
https://doi.org/10.37482/2687-1491-Z165Keywords:
COVID-19 pneumonia, lung computed tomography, degree of lung tissue damage, consequences of COVID-19, patient’s functional capacity, walk test, pulmonary rehabilitation, patient’s sexAbstract
Many COVID-19 survivors face various functional disorders. The purpose of this article was to determine the association between the degree of lung tissue damage and functional capacity of patients after COVID-19 pneumonia. Materials and methods. We examined patients (n = 264) aged 46–86 years that had suffered moderate or severe COVID-19 and undergone treatment for bilateral multisegmental pneumonia followed by rehabilitation. Functional capacity was measured using a walk test (at a normal pace to the first signs of exhaustion), taking into account heart rate (HR) and peripheral oxygen saturation (SpO2). The association between the degree of lung tissue damage and test results was analysed using simple and multiple regression analysis. Regression models included the following variables: walking distance, HR and SpO2 at rest and after the test, as well as demographic and clinical characteristics of patients. Results. At normal values of resting SpO2(96.3 ± 1.6 %) and resting HR (81.4 ± 12.1 bpm), fatigue occurred after walking the distance of 130.3 ± 96.4 m, SpO2 decreased to 93.8 ± 3.5 %, HR increased to 96.8 ± 14.0 bpm, the Borg score was 6 ± 3 points. Simple regression analysis showed a negative association of the degree of lung tissue damage with walking distance as well as with resting and after-test SpO2 and a positive association with resting HR. Multiple regression analysis indicated a tendency towards a greater decrease in walking distance and a larger increase in resting HR in men compared to women as well as an increase in walking distance and a reduction in resting HR in patients with chronic diabetes as the degree of lung tissue damage increased. Thus, greater degree of lung tissue damage is associated with decreased functional capacity in patients; however, the extent of this decrease may depend on their burdened history and sex.
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Sohrabi C., Alsafi Z., O’Neill N., Khan M., Kerwan A., Al-Jabir A., Iosifidis C., Agha R. World Health Organization Declares Global Emergency: A Review of the 2019 Novel Coronavirus (COVID-19) // Int. J. Surg. 2020. Vol. 76. P. 71–76. https://doi.org/10.1016/j.ijsu.2020.02.034
Torres-Castro R., Vasconcello-Castillo L., Alsina-Restoy X., Solis-Navarro L., Burgos F., Puppo H., Vilaró J. Respiratory Function in Patients Post-Infection by COVID-19: A Systematic Review and Meta-Analysis // Pulmonology. 2021. Vol. 27, № 4. P. 328–337. https://doi.org/10.1016/j.pulmoe.2020.10.013
Baratto C., Caravita S., Faini A., Perego G.B., Senni M., Badano L.P., Parati G. Impact of COVID-19 on Exercise Pathophysiology: A Combined Cardiopulmonary and Echocardiographic Exercise Study // J. Appl. Physiol. 2021. Vol. 130, № 5. P. 1470–1478. https://doi.org/10.1152/japplphysiol.00710.2020
Vitacca M., Paneroni M. Brunetti G., Carlucci A., Balbi B., Spanevello A., Ambrosino N. Characteristics of COVID-19 Pneumonia Survivors with Resting Normoxemia and Exercise-Induced Desaturation // Respir. Care. 2021. Vol. 66, № 11. P. 1657–1664. https://doi.org/10.4187/respcare.09029
Wang Y., Dong C., Hu Y., Li C., Ren Q., Zhang X., Shi H., Zhou M. Temporal Changes of CT Findings in 90 Patients with COVID-19 Pneumonia: A Longitudinal Study // Radiology. 2020. Vol. 296, № 2. Р. E55–E64. https://doi.org/10.1148/radiol.2020200843
Mo X., Jian W., Su Z., Chen M., Peng H., Peng P., Lei C., Chen R., Zhong N., Li S. Abnormal Pulmonary Function in COVID-19 Patients at Time of Hospital Discharge // Eur. Respir. J. 2020. Vol. 55, № 6. Art. № 2001217. https://doi.org/10.1183/13993003.01217-2020
Liu X., Zhang R., He G. Hematological Findings in Coronavirus Disease 2019: Indications of Progression of Disease // Ann. Hematol. 2020. Vol. 99, № 7. P. 1421–1428. https://doi.org/10.1007/s00277-020-04103-5
Rinaldo R.F., Mondoni M., Parazzini E.M., Pitari F., Brambilla E., Luraschi S., Balbi M., Sferrazza Papa G.F., Sotgiu G., Guazzi M., Di Marco F., Centanni S. Deconditioning as Main Mechanism of Impaired Exercise Response in COVID-19 Survivors // Eur. Respir. J. 2021. Vol. 58, № 2. Art. № 2100870. https://doi.org/10.1183/13993003.00870-2021
Pizarro-Pennarolli C., Sánchez-Rojas C., Torres-Castro R., Vera-Uribe R., Sanchez-Ramirez D.C., VasconcelloCastillo L., Solís-Cavarro L., Rivera-Lillo G. Assessment of Activities of Daily Living in Patients Post COVID-19: A Systematic Review // PeerJ. 2021. Vol. 9. Art. № e11026. https://doi.org/10.7717/peerj.11026
Ahmed I., Mustafaoglu R., Yeldan I., Yasaci Z., Erhan B. Effect of Pulmonary Rehabilitation Approaches on Dyspnea, Exercise Capacity, Fatigue, Lung Functions, and Quality of Life in Patients with COVID-19: A Systematic Review and Meta-Analysis // Arch. Phys. Med. Rehabil. 2022. Vol. 103, № 10. P. 2051–2062. https://doi.org/10.1016/j.apmr.2022.06.007
Paneroni M., Simonelli C., Saleri M., Bertacchini L., Venturelli M., Troosters T., Ambrosino N., Vitacca M. Muscle Strength and Physical Performance in Patients Without Previous Disabilities Recovering from COVID-19 Pneumonia // Am. J. Phys. Med. Rehabil. 2021. Vol. 100, № 2. P. 105–109. https://doi.org/10.1097/PHM.0000000000001641
Борчев К.Ф., Бондарев Д.В., Муромцев А.Б., Печерная Н.В. Изменения дыхательной и физической функций у пациентов среднего и пожилого возраста, перенесших COVID-19, после программы комплексной реабилитации // Успехи геронтологии. 2021. Т. 34, № 6. С. 934–940. https://doi.org/10.34922/AE.2021.34.6.016
Wong A.W., López-Romero S., Figueroa-Hurtado E., Vazquez-Lopez S., Milne K.M., Ryerson C.J., Guenette J.A., Cortés-Telles A. Predictors of Reduced 6-Minute Walk Distance After COVID-19: A Cohort Study in Mexico // Pulmonology. 2021. Vol. 27, № 6. P. 563–565. https://doi.org/10.1016/j.pulmoe.2021.03.004
Брико Н.И., Коршунов В.А., Краснова С.В., Проценко Д.Н., Глазовская Л.С., Гостищев Р.В., Салтыкова Т.С., Чернявская О.П., Поздняков А.А., Лабанович В.В., Канеев А.И. Клинико-эпидемиологические особенности пациентов, госпитализированных с COVID-19 в различные периоды пандемии в Москве // Журн. микробиологии, эпидемиологии и иммунобиологии. 2022. Т. 99, № 3. С. 287–299. https://doi.org/10.36233/0372-9311-272
Blitshteyn S., Whitelaw S. Postural Orthostatic Tachycardia Syndrome (POTS) and Other Autonomic Disorders After COVID-19 Infection: A Case Series of 20 Patients // Immunol. Res. 2021. Vol. 69, № 2. P. 205–211. https://doi.org/10.1007/s12026-021-09185-5
Мишина И.Е., Чистякова Ю.В., Пчелинцева Е.В., Митряева И.В., Фокичева С.О., Березина Е.В., Бендин Д.С. Эффективность медицинской реабилитации больных после новой коронавирусной инфекции в условиях дневного стационара // Вестн. восстанов. медицины. 2022. Т. 21, № 3. С. 9–23. https://doi.org/10.38025/2078-1962-2022-21-3-9-23
Cortés-Telles A., López-Romero S., Figueroa-Hurtado E., Pou-Aguilar Y.N., Wong A.W., Milne K.M., Ryerson C.J., Guenette J.A. Pulmonary Function and Functional Capacity in COVID-19 Survivors with Persistent Dyspnоea // Respir. Physiol. Neurobiol. 2021. Vol. 288. Art. № 103644. https://doi.org/10.1016/j.resp.2021.103644
Борчев К.Ф. Ассоциация степени поражения легочной ткани с временем произвольной задержки дыхания у взрослых лиц, перенесших COVID-19 // Журн. мед.-биол. исследований. 2022. Т. 10, № 4. С. 307–316. https://doi.org/10.37482/2687-1491-Z115
Eksombatchai D., Wongsinin T., Phongnarudech T., Thammavaranucupt K., Amornputtisathaporn N., Sungkanuparph S. Pulmonary Function and Six-Minute-Walk Test in Patients After Recovery from COVID-19: A Prospective Cohort Study // PLoS One. 2021. Vol. 16, № 9. Art. № e0257040. https://doi.org/10.1371/journal.pone.0257040
Kumar A., Narayan R.K., Kulandhasamy M., Prasoon P., Kumari C., Kumar S., Pareek V., Sesham K., Shekhawat P.S., Kant K., Kumar S. COVID-19 Pandemic: Insights into Molecular Mechanisms Leading to Sex-Based Differences in Patient Outcomes // Expert Rev. Mol. Med. 2021. № 23. Art. № e7. https://doi.org/10.1017/erm.2021.9
Moran K.R., Del Valle S.Y. A Meta-Analysis of the Association Between Gender and Protective Behaviors in Response to Respiratory Epidemics and Pandemics // PLoS One. 2016. Vol. 11, № 10. Art. № e0164541. https://doi.org/10.1371/journal.pone.0164541
Alwani M., Yassin A., Al-Zoubi R.M., Aboumarzouk O.M., Nettleship J., Kelly D., Al-Qudimat A.R., Shabsigh R. Sex-Based Differences in Severity and Mortality in COVID-19 // Rev. Med. Virol. 2021. Vol. 31, № 6. Art. № e2223. https://doi.org/10.1002/rmv.2223
Guan W.J., Liang W.H., Zhao Y., Liang H.R., Chen Z.S., Li Y.M., Liu X.Q., Chen R.C., Tang C.L., Wang T., et al. China Medical Treatment Expert Group for COVID-19. Comorbidity and Its Impact on 1590 Patients with COVID-19 in China: A Nationwide Analysis // Eur. Respir. J. 2020. Vol. 55, № 5. Art. № 2000547. https://doi.org/10.1183/13993003.00547-2020