Residual ground glass opacities three months after Covid-19 pneumonia correlate to alteration of respiratory function: The post Covid M3 study - 11/06/21
, Marie-Pierre Debray c, d, Samia Boussouar e, f, Antoine Khalil c, d, Catherine Bancal b, Justina Motiejunaite a, b, Maria Alejandra Galarza-Jimenez h, Hélène Benzaquen b, Dominique Penaud b, Pierantonio Laveneziana g, h, Roxane Malrin g, i, Alban Redheuil e, f, Victoria Donciu j, Olivier Lucidarme j, k, Camille Taillé c, l, Antoine Guerder g, i, Florence Arnoult b, Emmanuelle Vidal-Petiot b, m, Martin Flamant b, m, Thomas Similowski g, n, Capucine Morelot-Panzini g, n, Morgane Faure g, n, François-Xavier Lescure o, p, Christian Straus g, h, Marie-Pia d’Ortho a, b, Jésus Gonzalez-Bermejo g, i
Bienvenue sur EM-consulte, la référence des professionnels de santé.
Article gratuit.
Connectez-vous pour en bénéficier!
Abstract |
Introduction |
Lung function in survivors of SARS-Co-V2 pneumonia is poorly known, but concern over the possibility of sequelae exists.
Methods |
Retrospective study on survivors with confirmed infection and pneumonia on chest-CT. Correlations between PFT and residual radiologic anomalies at three months taking into account initial clinical and radiological severity and steroid use during acute phase.
Results |
137 patients (69 men, median age 59 (Q1 50; Q3 68), BMI 27.5 kg/m2 (25.1; 31.7)) were assessed. Only 32.9% had normal PFT, 75 had altered DLCO. Median (Q1; Q3) values were: VC 79 (66; 92) % pred, FEV1 81 (68; 89), TLC 78 (67; 85), DLCO 60 (44; 72), and KCO 89 (77; 105). Ground glass opacities (GGO) were present in 103 patients (75%), reticulations in 42 (30%), and fibrosis in 18 (13%). There were significantly lower FEV1 (p = 0.0089), FVC (p = 0.0010), TLC (p < 0.0001) and DLCO (p < 0.0001) for patients with GGO, lower TLC (p = 0.0913) and DLCO (p = 0.0181) between patients with reticulations and lower FVC (p = 0.0618), TLC (p = 0.0742) DLCO (p = 0.002) and KCO (p = 0.0114) between patients with fibrosis. Patients with initial ≥50% lung involvement had significantly lower FEV1 (p = 0.0019), FVC (p = 0.0033), TLC (p = 0.0028) and DLCO (p = 0.0003) compared to patients with ≤10%. There was no difference in PFT and residual CT lesions between patients who received steroids and those who did not.
Conclusion |
The majority of patients have altered PFT at three months, even in patients with mild initial disease, with significantly lower function in patients with residual CT lesions. Steroids do not seem to modify functional and radiological recovery. Long-term follow-up is needed.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Lung function impairment affects almost 70% of patients at three months after SARS-CoV-2 pneumonia, mostly diffusion capacity alteration. |
• | Residual ground glass opacities, reticulations or fibrosis are significantly correlated to lower DLCO at three months. |
• | Initial extensive pneumonia (at least 50% of parenchyma involvement) is associated with poorer lung function at three months (VC, FEV1, DLCO). |
• | In this retrospective study, steroids during acute phase had no effect on PFT values at three months. |
Keywords : SARS-CoV-2, Vital capacity, TLCO, Pneumonia, Chest CT, Invasive ventilation, ARDS, COVID-19
Plan
Vol 184
Article 106435- août 2021 Retour au numéro
Article précédent
- Safety and efficacy of omadacycline by body mass index in patients with community-acquired bacterial pneumonia: Subanalysis from a randomized controlled trial
- Manjunath P. Pai, Mark Wilcox, Surya Chitra, Paul McGovern
Bienvenue sur EM-consulte, la référence des professionnels de santé.