Comprehensive evaluation of the respiratory system, cardiovascular system, and psychoemotional disorders in post-COVID-19 adult patients

The aim was to study changes in the respiratory system, cardiovascular system, functional and psychoemotional status of adult patients after inpatient treatment for COVID-19 ( COronaVIrus Disease 2019). Methods. This cohort prospective observational study recruited patients with COVID-19 and lung damage. Transthoracic echocardiography, lung ultrasound, ECG, dyspnea assessment using mMRC and Borg scales, 6-minute walk test, and pulmonary function tests were performed 3 months after discharge from hospital. Psychoemotional status was assessed using MFI-20 international asthenia test, Spielberger–Hanin situational anxiety scale, Beck depression scale, MMSE cognitive function assessment scale. A standard set of statistical tools was used to describe and compare the data. The differences were considered statistically significant at p < 0.05. Results. A total of 51 patients were enrolled, including 29 (55.8%) women, the median age 64.5 (60.0 – 70.0) years. The most frequent complaints at 3 months after the hospital discharge were weakness (88.2%) and mild (62.7%) to moderate (29.4%) dyspnea. There was a decrease in the lung tissue lesions compared to inpatient treatment (14.5 vs 23.0 points), but the lung ultrasound found consolidates in 78.4% of the patients. The degree of lung tissue lesions correlated with the functional status of the patients. Decreased diffusion lung capacity (DL CO ) was the most frequent functional disorder. It was detected in 23.1% of the patients and accompanied by decreased 6-minute walk test distance and increased volume of lung lesions according to the ultrasound. The threshold value of ultrasound score indicative of the abnormal lung diffusion capacity was 24.5 at the stage of inpatient treatment and 15.5 points at 3 months after discharge from hospital. A mental status assessment at 3 months after discharge from hospital showed that asthenia persisted in all patients. Their anxiety and depression statistically significantly decreased, and the cognitive status improved. Conclusion. The majority of adult patients who had COVID-19 with lung damage still have complaints, lung tissue changes of varying severity at 3 months after discharge from hospital. A significant proportion of the patients also had psychoemotional disorders, abnormalities in the performance of functional tests, and impaired DL CO . Lung ultrasound can be considered an informative non-invasive method of assessing severity of the lung tissue damage, allowing to predict impaired gas transport function of the lungs.