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https://doi.org/10.14300/mnnc.2023.18085

Peculiarities of pulmonary ventilation disturbances in the dynamics of observation of patients survived COVID-19

[Internal diseases]
Olga Alekseevna Efremova; Vladislav Alexandrovich Dubrovа; Lyudmila Alexandrovna Kamyshnikova; Natalia Ivanovna Obolonkova; Olga Alexandrovna Bolkhovitina; Diana Borisovna Balinyan;

The clinical and gender features of pulmonary ventilation (PV) were studied in dynamics by examining respiratory functional tests in patients with severe Covid-associated pneumonia (CAP). Patients with severe and extremely severe CAP underwent spirometry upon admission to the hospital, a month, three, six and a year after the discharge from the hospital. Group 1 (58 patients) was treated in the intensive care unit (ICU), group 2 (40 patients) – in the therapeutic department (TD). Disorders of PV by restrictive or obstructive type were analyzed in relation to gender differences, clinical, anamnestic, laboratory and radiological parameters. In both cohorts, patients with a restrictive type of ventilation disorders prevailed. Gender differences in severe cases of Covid-associated pneumonia were not identified during follow-up. In patients treated in the therapeutic department, normalization of PV parameters occurred more quickly. After 12 months of observation, PV disturbances persisted in 27 (27.55 %) patients of group 1, in 8 (8.16 %) patients of group 2 (χ2=12.557; p<0.001). Factors that can help predicting long-term pathological changes in PV in post-COVID patients have been identified. (age, BMI >25 kg/m2, number of band neutrophils, prolonged febrile fever, persistence of cough with sputum production for a month or more from the moment of hospitalization of patients with pneumonia and duration of self-medication before hospitalization). Thus, in patients with severe and extremely severe pneumonia caused by COVID-19, pulmonary function and factors influencing the long-term prognosis of persistent respiratory failure should be assessed for rehabilitation and necessary treatment.

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Keywords: COVID-19, pneumonia, gender characteristics, pulmonary ventilation, respiratory function tests, spirometry