Longitudinal changes of diffusing capacity (DLCO) and dyspnoea after mild COVID-19
<italic><bold>Background:</bold></italic> Post-Covid-Syndrome (PCS) can be quantified by the PCS severity score (PCSS, Bahmer T et al, eClinicalMedicine, 2022). It is based on 12 self-reported symptom complexes, including subjective dyspnoea, which may result from impaired diffusing capacity of the lung (DLCO). <italic><bold>Objective:</bold></italic> We aimed to quantify longitudinal DLCO changes in patients after mild COVID-19 based on PCS severity (PCSS<sub>hi</sub> vs. PCSS<sub>lo</sub>). <italic><bold>Methods</bold><bold>:</bold></italic> COVIDOM is a prospective cohort study of SARS-CoV-2 infected individuals, recruited ≥6 months after PCR confirmation with <10% hospitalization rate in total. Follow-Ups (FUs) were scheduled 12-18 months after PCR testing. Dyspnoea was assessed using a standardized questionnaire (MDP-A1), DLCO was measured according to ERS criteria. <italic><bold>Results:</bold></italic> 2,993 participants had complete lung function data at baseline (BL) with a mean DLCO of 95.15 %pred (z-score −0.37); 8.5% of these showed relevant impairments (DLCO<LLN, GLI 2012). In PCSS<sub>hi</sub> vs. PCSS<sub>lo</sub> mean DLCO z-scores were −0.42±0.99 vs. −0.34±0.95 at BL and −0.54±0.95 vs. −0.38±1.00 at FU (all p>0.05). Median MDP-A1 differed significantly between both groups at BL (3 [IQR 1-5] vs. 0 [2-0]) and FU (2 [0-4] vs. 0 [1-0]) (all p<0.001). DLCO z-scores slightly worsened over time in both groups (p<0.05), while MDP-A1 scores improved in PCSS<sub>hi</sub> patients (p<0.05). <italic><bold>Conclusion:</bold></italic> In patients with mild acute COVID-19, marginal DLCO impairments did not differ between PCSS<sub>hi</sub> and PCSS<sub>lo</sub> at BL and FU. In contrast, PCSS<sub>hi</sub> patients had suffered more often from dyspnoea at BL, which markedly improved at FU, indicating that DLCO is not the appropriate measure to quantify breathlessness in PCS patients as reasons other than gas exchange impairment appear more relevant.
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)
- Eva Heim (ORCID: https://orcid.org/0000-0001-7434-7451)
- 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)
- Lennart Reinke
- Kelley Stanko
- 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)
- Henrik Watz (ORCID: https://orcid.org/0000-0003-1506-2661)
- Katrin Franzpötter
- Susanne Poick
- Stefan Schreiber
- Tamina Nichici
- Helen Beuter
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.pa5260
- Primary Topic
- Long-Term Effects of COVID-19
- Type
- article
- Field-Weighted Citation Impact
- 0.00