Small airway dysfunction in patients after mild COVID-19
<italic><bold>Background</bold></italic>: Small airway dysfunction (SAD) might be a feature of Post-COVID syndrome (PCS). SAD can be assessed by impulse oscillometry (IOS) in a tidal breathing maneuver, or by body plethysmography (BP) and forced spirometry (FS), both of which depend on investigator skill and patient adherence. <italic><bold>Objective</bold></italic>: We aimed to investigate the extent of SAD in PCS patients, who were severity graded by self-reported symptoms using a PCS score (PCSS, Bahmer et al., eClinicalMedicine, 2022). <italic><bold>Methods</bold></italic>: The multicenter, prospective COVIDOM study investigates sequelae of PCR-confirmed SARS-CoV-2 infections in individuals ≥6 months after acute COVID-19. IOS, BP and FS were performed according to ERS guidelines investigating frequency dependence of resistance (FDR<sub>abs</sub>/ R<sub>5-20Hz</sub>), RV/TLC, and FEV<sub>1</sub>/FVC. According to the PCSS, participants were grouped into none/mild (I), moderate (II) and severe PCS (III). <italic><bold>Results</bold></italic>: We included 2,811 valid lung function results in our analysis. 8.8% showed airflow limitation (FEV<sub>1</sub>/FVC <LLN), 20.1% hyperinflation (RV/TLC >ULN) (GLI 2012 reference values) and 40.5 % increased FDR<sub>abs</sub> (>0.03kPa/l/s). Comparing PCS-I to PCS-II and PCS-III, the z-score for FEV<sub>1</sub>/FVC (−0.36±1.08; −0.37±0.95; −0.30±1.01, p>0.05) did not differ between groups while the z-score for RV/TLC (0.77±1.25; 0.82±1.1; 0.90±1.18, p=0.03) and FDR<sub>abs</sub> displayed significant differences (0.032±0.08; 0.033±0.06; 0.043±0.06, p=0.001). <italic><bold>Conclusion</bold></italic>: Self-reported PCS severity was associated with SAD as assessed by IOS and BP. IOS needs little expertise in lung function testing and could therefore easily be integrated in PCS assessment. Despite broad availability, FEV<sub>1</sub> might be insensitive to the subtle changes of airway physiology in affected individuals.
Authors
- Thomas Bahmer (ORCID: https://orcid.org/0000-0002-7677-7057)
- Thomas Zöller (ORCID: https://orcid.org/0000-0002-9797-1692)
- Carolin Nürnberger (ORCID: https://orcid.org/0009-0007-1029-3707)
- Wolfgang Lieb (ORCID: https://orcid.org/0000-0003-2544-4460)
- Peter U. Heuschmann (ORCID: https://orcid.org/0000-0002-2681-3515)
- Klaus F. Rabe (ORCID: https://orcid.org/0000-0002-7020-1401)
- Anne-Kathrin Ruß (ORCID: https://orcid.org/0000-0002-4593-8698)
- Jörg Janne Vehreschild (ORCID: https://orcid.org/0000-0002-5446-7170)
- Anne‐Marie Kirsten (ORCID: https://orcid.org/0000-0002-2611-2962)
- Jan Heyckendorf (ORCID: https://orcid.org/0000-0003-4203-8421)
- Michael Krawczak (ORCID: https://orcid.org/0000-0003-2603-1502)
- Sina M. Hopff (ORCID: https://orcid.org/0000-0002-8886-4596)
- Stefan Schreiber (ORCID: https://orcid.org/0000-0003-2254-7771)
- Lennart Reinke
- Mustafa Abdo (ORCID: https://orcid.org/0000-0002-3300-1398)
- Stefan Störk (ORCID: https://orcid.org/0000-0002-1771-7249)
- Fridolin Steinbeis (ORCID: https://orcid.org/0000-0002-6955-9756)
- Edgar Heim
- Katrin Franzpötter
- Susanne Poick
- Helen Beuter
- Tamina Nichici
- Kira Stanko
Institutions
- Goethe University Frankfurt (DE)
- University of Würzburg (DE)
- Universitätsmedizin Greifswald (DE)
- Hochschule für Angewandte Wissenschaften Kiel (DE)
- Christian-Albrechts-Universität zu Kiel (DE)
- Humboldt-Universität zu Berlin (DE)
- Düsseldorf University Hospital (DE)
- University Hospital Schleswig-Holstein (DE)
- Universitätsklinikum Würzburg (DE)
- German Center for Lung Research (DE)
- University Hospital Cologne (DE)
- Clinical Research Center Kiel (DE)
- Heinrich Heine University Düsseldorf (DE)
- University of Lübeck (DE)
Publication Details
- Published
- 2024-09-14
- DOI
- https://doi.org/10.1183/13993003.congress-2024.pa5259
- Primary Topic
- Respiratory Support and Mechanisms
- Type
- article
- Field-Weighted Citation Impact
- 0.00