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Kautzky A, Nopp S, Gattinger D, Petrovic M, Antlinger M, Schomacker D, Kautzky-Willer A, Zwick RH. Sex differences of post-Covid patients undergoing outpatient pulmonary rehabilitation. Biol Sex Differ 2024; 15:36. [PMID: 38650012 PMCID: PMC11034076 DOI: 10.1186/s13293-024-00609-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 03/25/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Following years of pandemic severe acute respiratory syndrome coronavirus 2 infections labelled Covid-19, long lasting impairment summarized as post-Covid syndrome (PCS) challenges worldwide healthcare. Patients benefit from rehabilitation programs, but sex specific aspects of improvement remain little understood. The aim of the study was to assess whether women and men differ in response to outpatient pulmonary rehabilitation for PCS. METHODS 263 (54.4% female) patients partaking in outpatient pulmonary rehabilitation (OPR) due to PCS between March 2020 and July 2022 were included in a prospective observational cohort study. Outcomes were assessed at baseline and before discharge from OPR and included six-minute walking distance (6MWD), 1-second forced expiratory volume (FEV1), diffusion capacity for carbon monoxide, maximal inspiratory pressure (MIP), dyspnea (medical research council scale), and post-Covid functional status scale (PCFS). Sexspecific changes in outcomes following OPR were assessed by linear mixed model and presented as mean differences (MD) with 95% confidence intervals. Linear regression was applied to test whether 6MWD correlates with PCFS and the minimal clinically important difference (MCID) in 6MWD regarding an improvement of at least one point in PCFS was computed with logistic regression. RESULTS Significant improvement throughout OPR was observed for all outcomes (all p < 0.0001). Despite less severe Covid-19 infections, PCFS scores remained higher in females after OPR (p = 0.004) and only 19.4% of women compared to 38.5% of men achieved remission of functional impairment. At baseline as well as after OPR, females showed higher symptom load compared to men in dyspnea (p = 0.0027) and scored lower in FEV1 (p = 0.009) and MIP (p = 0.0006) assessment. Performance in 6MWD was comparable between men and women. An increase of 35 m in 6MWD was computed as minimal clinically important difference to improve functional impairment. CONCLUSION Both subjective symptoms such as fatigue and dyspnea and objective impairment in performance in pulmonary function were more frequently observed among women. Despite improvement throughout OPR in both women and men, the sex-gap in symptom load could not be closed as women less often achieved remission from functional impairment due to PCS. Intensified treatment of these symptoms should be considered in women undergoing rehabilitation for PCS.
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Affiliation(s)
- Alexander Kautzky
- Clinical Division of Social Psychiatry, Department for Psychiatry and Psychotherapy, Medical University if Vienna, Vienna, Austria
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Stephan Nopp
- Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Dietlinde Gattinger
- Outpatient Pulmonary Rehabilitation, Therme Wien Med, Vienna, Austria
- Ludwig Boltzmann Institute for Rehabilitation Research, Vienna, Austria
| | - Milos Petrovic
- Outpatient Pulmonary Rehabilitation, Therme Wien Med, Vienna, Austria
| | - Martin Antlinger
- Clinical Division of Social Psychiatry, Department for Psychiatry and Psychotherapy, Medical University if Vienna, Vienna, Austria
| | - Dustin Schomacker
- Clinical Division of Social Psychiatry, Department for Psychiatry and Psychotherapy, Medical University if Vienna, Vienna, Austria
| | - Alexandra Kautzky-Willer
- Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Ralf Harun Zwick
- Outpatient Pulmonary Rehabilitation, Therme Wien Med, Vienna, Austria.
- Ludwig Boltzmann Institute for Rehabilitation Research, Vienna, Austria.
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Björnson M, Svensson AM, He C, Sköld M, Nyrén S, Nygren-Bonnier M, Bruchfeld J, Runold M, Jalde FC, Kistner A. Residual radiological opacities correlate with disease outcomes in ICU-treated COVID-19. Front Med (Lausanne) 2024; 11:1263511. [PMID: 38633311 PMCID: PMC11021575 DOI: 10.3389/fmed.2024.1263511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 03/07/2024] [Indexed: 04/19/2024] Open
Abstract
Background Few studies consider both radiological and functional outcomes in COVID-19 survivors treated in the intensive care unit (ICU). We investigated clinical findings and pulmonary abnormalities on chest computed tomography (CT) and compared outcomes of severe versus mild-moderate acute respiratory distress syndrome (ARDS) on long-term follow-up. Methods This longitudinal cohort study included 118 COVID-19 patients (median age, 58 years; 79% men). Thoracic CT scans were performed 4, 10, and 22 months after hospital discharge. Two independent blinded radiologists analyzed the 10 months scans and scored the radiology findings semi-quantitatively, as no/minor versus widespread opacities [low-radiology opacity grade (ROG) versus high-ROG]. ARDS severity was based on the PaO2/FiO2 ratio. The 6 min walk test (6MWT) was performed after 3 and 9 months, and lung diffusion capacity for carbon monoxide (DLCO) and lung volume measurement after 9 and 15 months. Dynamic spirometry was done at all time points. Residual symptoms and health-related quality-of-life (HRQL) were evaluated using validated questionnaires. Results At 10 months, most patients (81/118; 69%) were classified as high-ROG, of which 70% had severe ARDS during hospitalisation; 69% of those with mild-moderate ARDS also had high-ROG. Patients with high-ROG had longer ICU stay and lower PaO2/FiO2 during hospitalisation (p < 0.01). At 9 months follow-up, patients with high-ROG had smaller lung volumes as % of predicted values [mean (±CI): 80 (77-84) vs. 93 (88-98) (p < 0.001)], lower DLCO as % of predicted values [74 (70-78) vs. 87 (82-92) (p < 0.001)], lower oxygen saturation during 6MWT (p = 0.02), and a tendency to more severe dyspnoea (p = 0.07), but no difference was found in HRQL compared with no/minor ROG (p = 0.92). A higher opacity score was related to lower DLCO at follow-up (r = -0.48, p < 0.001, Spearman rank test). Severe ARDS patients had slightly more severe fatigue at 9 months compared to mild-moderate, but no differences in dyspnoea or lung function at follow-up. Fibrotic-like changes were found in 93% of patients examined with CT scans at 2 years (55/118; 47%). Severe ARDS could predict widespread opacities (ROG > 25%) in most patients at follow-up at 10 months (AUC 0.74). Conclusion Residual radiological abnormalities in ICU-treated COVID-19 patients, evaluated for up to 2 years, relate to persisting symptoms and impaired lung function, demanding careful follow-up regardless of ARDS severity at hospitalisation.
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Affiliation(s)
- Mikael Björnson
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine Solna, Division of Infection Diseases, Karolinska Institutet, Stockholm, Sweden
| | - Ann Mari Svensson
- Department of Radiology, Karolinska University Hospital, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Cecilia He
- Department of Radiology, Karolinska University Hospital, Stockholm, Sweden
| | - Magnus Sköld
- Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Stockholm, Sweden
- Respiratory Medicine Unit, Department of Medicine Solna and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Sven Nyrén
- Department of Radiology, Karolinska University Hospital, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Malin Nygren-Bonnier
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden
- Women’s Health and Allied Health Professionals Theme, Medical Unit Allied Health Professionals, Karolinska University Hospital, Stockholm, Sweden
| | - Judith Bruchfeld
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine Solna, Division of Infection Diseases, Karolinska Institutet, Stockholm, Sweden
| | - Michael Runold
- Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Stockholm, Sweden
- Respiratory Medicine Unit, Department of Medicine Solna and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Francesca Campoccia Jalde
- Department of Cardiothoracic Surgery and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Anna Kistner
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden
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Cornelissen ME, Leliveld A, Baalbaki N, Gach D, van der Lee I, Nossent EJ, Bloemsma LD, Maitland-van der Zee AH. Pulmonary function 3-6 months after acute COVID-19: A systematic review and multicentre cohort study. Heliyon 2024; 10:e27964. [PMID: 38533004 PMCID: PMC10963328 DOI: 10.1016/j.heliyon.2024.e27964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 02/22/2024] [Accepted: 03/08/2024] [Indexed: 03/28/2024] Open
Abstract
Aims To describe pulmonary function 3-6 months following acute COVID-19, to evaluate potential predictors of decreased pulmonary function and to review literature for the effect of COVID-19 on pulmonary function. Materials and methods A systematic review and cohort study were conducted. Within the P4O2 COVID-19 cohort, 95 patients aged 40-65 years were recruited from outpatient post-COVID-19 clinics in five Dutch hospitals between May 2021-September 2022. At 3-6 months post COVID-19, medical records data and biological samples were collected and questionnaires were administered. In addition, pulmonary function tests (PFTs), including spirometry and transfer factor, were performed. To identify factors associated with PFTs, linear regression analyses were conducted, adjusted for covariates. Results In PFTs (n = 90), mean ± SD % of predicted was 89.7 ± 18.2 for forced vital capacity (FVC) and 79.8 ± 20.0 for transfer factor for carbon monoxide (DLCO). FVC was Conclusion A low DLCO 3-6 months following acute COVID-19 was observed more often than a low FVC, both in the P4O2 COVID-19 study and the literature review.
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Affiliation(s)
- Merel E.B. Cornelissen
- Department of Pulmonary Medicine, Amsterdam UMC, University of Amsterdam, 1105, AZ Amsterdam, the Netherlands
- Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
- Amsterdam Public Health, Amsterdam, the Netherlands
| | - Asabi Leliveld
- Department of Pulmonary Medicine, Amsterdam UMC, University of Amsterdam, 1105, AZ Amsterdam, the Netherlands
- Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
- Amsterdam Public Health, Amsterdam, the Netherlands
| | - Nadia Baalbaki
- Department of Pulmonary Medicine, Amsterdam UMC, University of Amsterdam, 1105, AZ Amsterdam, the Netherlands
- Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
- Amsterdam Public Health, Amsterdam, the Netherlands
| | - Debbie Gach
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, the Netherlands
- School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands
| | - Ivo van der Lee
- Department of Pulmonology, Spaarne Hospital, the Netherlands
| | - Esther J. Nossent
- Department of Pulmonary Medicine, Amsterdam UMC, University of Amsterdam, 1105, AZ Amsterdam, the Netherlands
| | - Lizan D. Bloemsma
- Department of Pulmonary Medicine, Amsterdam UMC, University of Amsterdam, 1105, AZ Amsterdam, the Netherlands
- Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
- Amsterdam Public Health, Amsterdam, the Netherlands
| | - Anke H. Maitland-van der Zee
- Department of Pulmonary Medicine, Amsterdam UMC, University of Amsterdam, 1105, AZ Amsterdam, the Netherlands
- Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
- Amsterdam Public Health, Amsterdam, the Netherlands
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do Amaral CMSSB, da Luz Goulart C, da Silva BM, Valente J, Rezende AG, Fernandes E, Cubas-Vega N, Borba MGS, Sampaio V, Monteiro W, de Melo GC, Lacerda M, Arêas GPT, Almeida-Val F. Low handgrip strength is associated with worse functional outcomes in long COVID. Sci Rep 2024; 14:2049. [PMID: 38267519 PMCID: PMC10808118 DOI: 10.1038/s41598-024-52401-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 01/18/2024] [Indexed: 01/26/2024] Open
Abstract
The diagnosis of long COVID is troublesome, even when functional limitations are present. Dynapenia is the loss of muscle strength and power production that is not caused by neurologic or muscular diseases, being mostly associated with changes in neurologic function and/or the intrinsic force-generating properties of skeletal muscle, which altogether, may partially explain the limitations seen in long COVID. This study aimed to identify the distribution and possible associations of dynapenia with functional assessments in patients with long COVID. A total of 113 patients with COVID-19 were evaluated by functional assessment 120 days post-acute severe disease. Body composition, respiratory muscle strength, spirometry, six-minute walk test (6MWT, meters), and hand-grip strength (HGS, Kilogram-force) were assessed. Dynapenia was defined as HGS < 30 Kgf (men), and < 20 Kgf (women). Twenty-five (22%) participants were dynapenic, presenting lower muscle mass (p < 0.001), worse forced expiratory volume in the first second (FEV1) (p = 0.0001), lower forced vital capacity (p < 0.001), and inspiratory (p = 0.007) and expiratory (p = 0.002) peek pressures, as well as worse 6MWT performance (p < 0.001). Dynapenia, independently of age, was associated with worse FEV1, maximal expiratory pressure (MEP), and 6MWT, (p < 0.001) outcomes. Patients with dynapenia had higher intensive care unit (ICU) admission rates (p = 0.01) and need for invasive mechanical ventilation (p = 0.007) during hospitalization. The HGS is a simple, reliable, and low-cost measurement that can be performed in outpatient clinics in low- and middle-income countries. Thus, HGS may be used as a proxy indicator of functional impairment in this population.
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Affiliation(s)
- Camila Miriam Suemi Sato Barros do Amaral
- Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Av. Pedro Teixeira, -25 - Bairro Dom Pedro, Manaus, AM, Brazil
- Universidade do Estado Do Amazonas, Manaus, AM, Brazil
| | - Cássia da Luz Goulart
- Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Av. Pedro Teixeira, -25 - Bairro Dom Pedro, Manaus, AM, Brazil
| | - Bernardo Maia da Silva
- Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Av. Pedro Teixeira, -25 - Bairro Dom Pedro, Manaus, AM, Brazil
| | - Jefferson Valente
- Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Av. Pedro Teixeira, -25 - Bairro Dom Pedro, Manaus, AM, Brazil
| | | | | | - Nadia Cubas-Vega
- Universidad Nacional Autónoma de Honduras, Tegucigalpa, FM, Honduras
| | - Mayla Gabriela Silva Borba
- Universidade do Estado Do Amazonas, Manaus, AM, Brazil
- Hospital e Pronto-Socorro Delphina Rinaldi Abdel Aziz, Manaus, AM, Brazil
| | | | - Wuelton Monteiro
- Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Av. Pedro Teixeira, -25 - Bairro Dom Pedro, Manaus, AM, Brazil
- Universidade do Estado Do Amazonas, Manaus, AM, Brazil
| | - Gisely Cardoso de Melo
- Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Av. Pedro Teixeira, -25 - Bairro Dom Pedro, Manaus, AM, Brazil
- Universidade do Estado Do Amazonas, Manaus, AM, Brazil
| | - Marcus Lacerda
- Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Av. Pedro Teixeira, -25 - Bairro Dom Pedro, Manaus, AM, Brazil
- Universidade do Estado Do Amazonas, Manaus, AM, Brazil
- Instituto Todos Pela Saúde, São Paulo, SP, Brazil
- Instituto Leônidas & Maria Deane/Fundação Oswaldo Cruz (ILMD/Fiocruz Amazônia), Manaus, Brazil
| | | | - Fernando Almeida-Val
- Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Av. Pedro Teixeira, -25 - Bairro Dom Pedro, Manaus, AM, Brazil.
- Universidade do Estado Do Amazonas, Manaus, AM, Brazil.
- Universidade Federal do Amazonas, Manaus, AM, Brazil.
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Pietruszka-Wałęka E, Rząd M, Żabicka M, Rożyńska R, Miklusz P, Zieniuk-Lesiak E, Jahnz-Różyk K. Impact of Symptomatology, Clinical and Radiological Severity of COVID-19 on Pulmonary Function Test Results and Functional Capacity during Follow-Up among Survivors. J Clin Med 2023; 13:45. [PMID: 38202052 PMCID: PMC10779755 DOI: 10.3390/jcm13010045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/10/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
One of the most commonly observed complications after COVID-19 is persistent pulmonary impairment. The aim of this study was to evaluate the impact of individual factors during the acute phase of COVID-19 on subsequent pulmonary function test results. The study involved 46 patients who were admitted to hospital due to respiratory failure caused by SARS-CoV-2 and who were assessed during follow-up visits at 3 and 9 months after discharge. Patients were divided into two subgroups according to the severity of respiratory failure. The severe group included patients requiring mechanical ventilation or HFNOT. The results of the study showed that a severe course of the disease was associated with a lower FVC and a higher FEV1/FVC ratio 3 months after discharge (both p < 0.05). In addition, it has been revealed that the length of hospitalization is a factor that negatively impacts the FEV1, FVC and TLC values measured at follow-up after 3 months. Furthermore, the obtained results identify the presence of cough in the acute phase of the disease as a factor having a positive impact on several PFT parameters (especially the FEV1/FVC ratio) as well as the 6MWT outcome after 3 months. The FVC improved significantly (p < 0.05) between the follow-up visits. The findings may indicate that COVID-19-induced respiratory dysfunction is usually temporary and spontaneously resolves during recovery. Recovery is slower in those who required more intensive oxygenation. The results of this study may be useful in identifying patients who require more intensive and longer rehabilitation after COVID-19.
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Affiliation(s)
- Ewa Pietruszka-Wałęka
- Department of Internal Medicine, Pneumonology, Allergology and Clinical Immunology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
| | - Michał Rząd
- Department of Internal Medicine, Pneumonology, Allergology and Clinical Immunology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
| | - Magdalena Żabicka
- Department of Radiology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
| | - Renata Rożyńska
- Department of Internal Medicine, Pneumonology, Allergology and Clinical Immunology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
| | - Piotr Miklusz
- Department of Internal Medicine, Pneumonology, Allergology and Clinical Immunology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
| | - Emilia Zieniuk-Lesiak
- Department of Internal Medicine, Pneumonology, Allergology and Clinical Immunology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
| | - Karina Jahnz-Różyk
- Department of Internal Medicine, Pneumonology, Allergology and Clinical Immunology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
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Stoichita A, Ghita M, Mahler B, Vlasceanu S, Ghinet A, Mosteanu M, Cioacata A, Udrea A, Marcu A, Mitra GD, Ionescu CM, Iliesiu A. Imagistic Findings Using Artificial Intelligence in Vaccinated versus Unvaccinated SARS-CoV-2-Positive Patients Receiving In-Care Treatment at a Tertiary Lung Hospital. J Clin Med 2023; 12:7115. [PMID: 38002725 PMCID: PMC10672398 DOI: 10.3390/jcm12227115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/27/2023] [Accepted: 11/04/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND In December 2019 the World Health Organization announced that the widespread severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection had become a global pandemic. The most affected organ by the novel virus is the lung, and imaging exploration of the thorax using computer tomography (CT) scanning and X-ray has had an important impact. MATERIALS AND METHODS We assessed the prevalence of lung lesions in vaccinated versus unvaccinated SARS-CoV-2 patients using an artificial intelligence (AI) platform provided by Medicai. The software analyzes the CT scans, performing the lung and lesion segmentation using a variant of the U-net convolutional network. RESULTS We conducted a cohort study at a tertiary lung hospital in which we included 186 patients: 107 (57.52%) male and 59 (42.47%) females, of which 157 (84.40%) were not vaccinated for SARS-CoV-2. Over five times more unvaccinated patients than vaccinated ones are admitted to the hospital and require imaging investigations. More than twice as many unvaccinated patients have more than 75% of the lungs affected. Patients in the age group 30-39 have had the most lung lesions at almost 69% of both lungs affected. Compared to vaccinated patients with comorbidities, unvaccinated patients with comorbidities had developed increased lung lesions by 5%. CONCLUSION The study revealed a higher percentage of lung lesions among unvaccinated SARS-CoV-2-positive patients admitted to The National Institute of Pulmonology "Marius Nasta" in Bucharest, Romania, underlining the importance of vaccination and also the usefulness of artificial intelligence in CT interpretation.
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Affiliation(s)
- Alexandru Stoichita
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania; (B.M.); (S.V.); (A.I.)
- “Marius Nasta” Institute of Pneumology, 050159 Bucharest, Romania; (A.G.); (M.M.); (A.C.)
| | - Maria Ghita
- Research Group of Dynamical Systems and Control, Ghent University, 9052 Ghent, Belgium; (M.G.); (C.M.I.)
- Faculty of Medicine and Health Sciences, Antwerp University, 2610 Wilrijk, Belgium
| | - Beatrice Mahler
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania; (B.M.); (S.V.); (A.I.)
- “Marius Nasta” Institute of Pneumology, 050159 Bucharest, Romania; (A.G.); (M.M.); (A.C.)
| | - Silviu Vlasceanu
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania; (B.M.); (S.V.); (A.I.)
- “Marius Nasta” Institute of Pneumology, 050159 Bucharest, Romania; (A.G.); (M.M.); (A.C.)
| | - Andreea Ghinet
- “Marius Nasta” Institute of Pneumology, 050159 Bucharest, Romania; (A.G.); (M.M.); (A.C.)
| | - Madalina Mosteanu
- “Marius Nasta” Institute of Pneumology, 050159 Bucharest, Romania; (A.G.); (M.M.); (A.C.)
- Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Andreea Cioacata
- “Marius Nasta” Institute of Pneumology, 050159 Bucharest, Romania; (A.G.); (M.M.); (A.C.)
| | - Andreea Udrea
- Medicai, 020961 Bucharest, Romania; (A.U.); (A.M.); (G.D.M.)
| | - Alina Marcu
- Medicai, 020961 Bucharest, Romania; (A.U.); (A.M.); (G.D.M.)
| | | | - Clara Mihaela Ionescu
- Research Group of Dynamical Systems and Control, Ghent University, 9052 Ghent, Belgium; (M.G.); (C.M.I.)
- Automation Department, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania
| | - Adriana Iliesiu
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania; (B.M.); (S.V.); (A.I.)
- Clinical Hospital “Prof. Dr. Th. Burghele”, 061344 Bucharest, Romania
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7
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Tariq J, Kumar S. Response to - "Evaluation of Pulmonary Function and Exercise Capacity After COVID-19 Pneumonia''. Curr Probl Cardiol 2023; 48:101784. [PMID: 37172866 PMCID: PMC10171894 DOI: 10.1016/j.cpcardiol.2023.101784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 05/07/2023] [Indexed: 05/15/2023]
Affiliation(s)
- Jawaria Tariq
- Karachi Medical And Dental College, Karachi, Pakistan.
| | - Satesh Kumar
- Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, Pakistan.
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Chaiwong W, Deesomchok A, Pothirat C, Liwsrisakun C, Duangjit P, Bumroongkit C, Theerakittikul T, Limsukon A, Tajarernmuang P, Trongtrakul K, Niyatiwatchanchai N. The long-term impact of COVID-19 pneumonia on pulmonary function and exercise capacity. J Thorac Dis 2023; 15:4725-4735. [PMID: 37868845 PMCID: PMC10586982 DOI: 10.21037/jtd-23-514] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 08/04/2023] [Indexed: 10/24/2023]
Abstract
Background The sequelae of post-coronavirus disease 2019 (COVID-19) have been widely reported. However, the time point of the follow-up time in the previous studies varied ranging from 3-24 months and the interval time of the follow-up time was too long (6 or 12 months). Thus, a shorter interval time during recovery for assessment of the sequelae of post COVID-19 on lung function and exercise capacity is still required. Therefore, this study aims to explore the long-term impact of COVID-19 pneumonia on pulmonary function and exercise capacity. Methods A prospective observational study was conducted on post COVID-19 pneumonia at the Lung Health Center, Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand between May 2021 and April 2022. Spirometry, impulse oscillometry (IOS), and fractional exhaled nitric oxide (FeNO) were assessed at 1-, 6-, 9-, and 12-month post-hospital discharge when compared to healthy controls. The six-minute walk test (6-MWT) was also assessed. Results Thirty-eight post COVID-19 pneumonia with ages 41.1±14.8 years (52.6% male) and twenty-five healthy controls were enrolled. The %predicted of forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1) were significantly lower in post COVID-19 pneumonia compared to healthy controls at month 1 and month 9. The improvement of %predicted FVC and FEV1 was observed in post COVID-19 pneumonia. The six-minute walk distance (6-MWD) was significantly lower in post COVID-19 pneumonia compared to healthy controls in all visits, while the 6-MWD improved overtime in post COVID-19 pneumonia. Conclusions The long term sequelae of post COVID-19 pneumonia on lung function and exercise capacity were observed. Pulmonary function tests and six-minutes walk test are useful tools for detection of long term sequelae of post COVID-19 pneumonia.
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Affiliation(s)
| | | | - Chaicharn Pothirat
- Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Chalerm Liwsrisakun
- Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Pilaiporn Duangjit
- Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Chaiwat Bumroongkit
- Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Theerakorn Theerakittikul
- Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Atikun Limsukon
- Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Pattraporn Tajarernmuang
- Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Konlawij Trongtrakul
- Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nutchanok Niyatiwatchanchai
- Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Sánchez-García JC, Rentero Moreno M, Piqueras-Sola B, Cortés-Martín J, Liñán-González A, Mellado-García E, Rodriguez-Blanque R. Physical Therapies in the Treatment of Post-COVID Syndrome: A Systematic Review. Biomedicines 2023; 11:2253. [PMID: 37626749 PMCID: PMC10452406 DOI: 10.3390/biomedicines11082253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
INTRODUCTION Several days to months after diagnosis of SARS-CoV-2, 35% of patients have persistent symptoms in high incidence. This is referred to as post-COVID-19 Syndrome. There is a pressing need to find a way to help patients with the manifested symptoms. OBJECTIVE To show the different therapies that exist for post-COVID Syndrome and their efficacy. METHODOLOGY A systematic review of the scientific literature was carried out. The data search was carried out in Scopus, PubMed, Cinahl, and Web of Science. Of the 106 articles found, 12 articles were obtained after applying the following eligibility criteria. RESULTS Interventions related to respiratory musculature and moderate intensity exercise both in supervised face-to-face sessions and in supervised home sessions led patients to a significant improvement in the symptoms presented. CONCLUSION Physical therapies significantly reduce fatigue and dyspnea as well as other symptoms related to quality of life.
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Affiliation(s)
- Juan Carlos Sánchez-García
- Research Group CTS1068, Andalusia Research Plan, Junta de Andalucía, School of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (J.C.S.-G.); (B.P.-S.); (A.L.-G.); (E.M.-G.); (R.R.-B.)
- School of Nursing, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain;
| | - María Rentero Moreno
- School of Nursing, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain;
| | - Beatriz Piqueras-Sola
- Research Group CTS1068, Andalusia Research Plan, Junta de Andalucía, School of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (J.C.S.-G.); (B.P.-S.); (A.L.-G.); (E.M.-G.); (R.R.-B.)
- University Hospital Virgen de las Nieves, 18014 Granada, Spain
| | - Jonathan Cortés-Martín
- Research Group CTS1068, Andalusia Research Plan, Junta de Andalucía, School of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (J.C.S.-G.); (B.P.-S.); (A.L.-G.); (E.M.-G.); (R.R.-B.)
- School of Nursing, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain;
| | - Antonio Liñán-González
- Research Group CTS1068, Andalusia Research Plan, Junta de Andalucía, School of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (J.C.S.-G.); (B.P.-S.); (A.L.-G.); (E.M.-G.); (R.R.-B.)
- School of Nursing, Faculty of Health Sciences, Melilla Campus, University of Granada, 52005 Melilla, Spain
| | - Elena Mellado-García
- Research Group CTS1068, Andalusia Research Plan, Junta de Andalucía, School of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (J.C.S.-G.); (B.P.-S.); (A.L.-G.); (E.M.-G.); (R.R.-B.)
- Costa del Sol Health District, 29640 Fuengirola, Spain
| | - Raquel Rodriguez-Blanque
- Research Group CTS1068, Andalusia Research Plan, Junta de Andalucía, School of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (J.C.S.-G.); (B.P.-S.); (A.L.-G.); (E.M.-G.); (R.R.-B.)
- School of Nursing, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain;
- University Hospital San Cecilio, 18071 Granada, Spain
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10
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Larrateguy S, Vinagre J, Londero F, Dabin J, Ricciardi E, Jeanpaul S, Torres-Castro R, Núñez-Cortés R, Sánchez-Ramírez D, Gimeno-Santos E, Blanco I. Clinical Variables Related to Functional Capacity and Exertional Desaturation in Patients with COVID-19. Biomedicines 2023; 11:2051. [PMID: 37509690 PMCID: PMC10377716 DOI: 10.3390/biomedicines11072051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/01/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023] Open
Abstract
Impaired functional capacity is one of the most commonly reported consequences among post-COVID-19 patients. This study aimed to analyse the clinical variables related to functional capacity and exertional desaturation in post-COVID-19 patients at the time of hospital discharge. A cross-sectional study was conducted on patients recovering from COVID-19 pneumonia. The main outcomes measures were functional capacity, assessed using the 1 min sit-to-stand test (1 min STST), and exertional desaturation, defined as a drop of ≥4% in the arterial oxygen saturation. Factors used to characterise the participant outcomes included the use of a high-flow nasal cannula (HFNC), prolonged hospitalisation, occurrence of pulmonary embolism during hospitalisation, and underlying comorbidities. A total of 381 participants (mean age = 53.7 ± 13.2 years, 65.6% men) were included. Participants completed a mean of 16.9 ± 6.2 repetitions in the 1 min STST. Exertional desaturation was observed in 51% of the patients. Higher odds of exertional desaturation were found in the participants who used a HFNC (OR = 3.6; 95%CI: 1.6 to 7.8), were admitted in the hospital >10 days (OR = 4.2; 95%CI: 2.6 to 6.8), and had a pulmonary embolism (OR = 3.5; 95%CI: 2.2. to 5.3). Use of a HFNC (β = -3.4; 95%CI: -5.3 to -1.44), a hospital stay >10 days (β = -2.2; 95%CI: -3.4 to -0.9), and a history of pulmonary embolism (β = -1.4; 95%CI: -2.6 to -0.2) were also negatively associated with the 1 min STST. Most post-COVID-19 patients exhibited reduced functional capacity at the time of hospital discharge, and approximately half had exertional desaturation after the 1 min STST. The use of a HFNC, prolonged hospitalisation and pulmonary embolism were the main clinical variables associated with worse a 1 min STST performance and a higher likelihood of exertional desaturation.
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Affiliation(s)
- Santiago Larrateguy
- Servicio de Kinesiología y Fisioterapia, Hospital de la Baxada “Dra. Teresa Ratto”, Paraná 3100, Argentina; (S.L.); (J.V.); (F.L.); (J.D.); (E.R.); (S.J.)
- Facultad de Ciencias de la Salud, Universidad Adventista del Plata, Libertador San Martin 3103, Argentina
| | - Julian Vinagre
- Servicio de Kinesiología y Fisioterapia, Hospital de la Baxada “Dra. Teresa Ratto”, Paraná 3100, Argentina; (S.L.); (J.V.); (F.L.); (J.D.); (E.R.); (S.J.)
| | - Federico Londero
- Servicio de Kinesiología y Fisioterapia, Hospital de la Baxada “Dra. Teresa Ratto”, Paraná 3100, Argentina; (S.L.); (J.V.); (F.L.); (J.D.); (E.R.); (S.J.)
| | - Johana Dabin
- Servicio de Kinesiología y Fisioterapia, Hospital de la Baxada “Dra. Teresa Ratto”, Paraná 3100, Argentina; (S.L.); (J.V.); (F.L.); (J.D.); (E.R.); (S.J.)
| | - Evangelina Ricciardi
- Servicio de Kinesiología y Fisioterapia, Hospital de la Baxada “Dra. Teresa Ratto”, Paraná 3100, Argentina; (S.L.); (J.V.); (F.L.); (J.D.); (E.R.); (S.J.)
| | - Santiago Jeanpaul
- Servicio de Kinesiología y Fisioterapia, Hospital de la Baxada “Dra. Teresa Ratto”, Paraná 3100, Argentina; (S.L.); (J.V.); (F.L.); (J.D.); (E.R.); (S.J.)
| | - Rodrigo Torres-Castro
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago 8380453, Chile; (R.T.-C.); (R.N.-C.)
- Department of Pulmonary Medicine, Hospital Clínic, University of Barcelona, 08036 Barcelona, Spain;
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
| | - Rodrigo Núñez-Cortés
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago 8380453, Chile; (R.T.-C.); (R.N.-C.)
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, 46003 Valencia, Spain
| | - Diana Sánchez-Ramírez
- Department of Respiratory Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB R3T 2N2, Canada;
| | - Elena Gimeno-Santos
- Department of Pulmonary Medicine, Hospital Clínic, University of Barcelona, 08036 Barcelona, Spain;
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
- Biomedical Research Networking Center on Respiratory Diseases (CIBERES), 30627 Madrid, Spain
- Barcelona Institute for Global Health (ISGlobal), 08036 Barcelona, Spain
| | - Isabel Blanco
- Department of Pulmonary Medicine, Hospital Clínic, University of Barcelona, 08036 Barcelona, Spain;
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
- Biomedical Research Networking Center on Respiratory Diseases (CIBERES), 30627 Madrid, Spain
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11
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Santafe-Abril G, Hurtado-Alzate C, Placencia-Silva M. Response to "Evaluation of pulmonary function and exercise capacity after COVID-19 pneumonia.". Heart Lung 2023:S0147-9563(23)00099-7. [PMID: 37085436 PMCID: PMC10086102 DOI: 10.1016/j.hrtlng.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 04/04/2023] [Indexed: 04/23/2023]
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12
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Levi G, Scaramozzino MU, Cavallo S, Castignini G, Bezzi M, Pini L, Nania F, Sheenam S. Pulmonary rehabilitation improves functional outcomes and quality of life in post-SARS-CoV-2 mild-to-moderate infection patients: a pilot study. Monaldi Arch Chest Dis 2023; 94. [PMID: 37017213 DOI: 10.4081/monaldi.2023.2524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 04/03/2023] [Indexed: 04/05/2023] Open
Abstract
SARS-CoV-2 infection impairs functional outcomes and quality of life, even in its mild-to-moderate form. Therefore, it is appropriate to draw attention to the role played by respiratory rehabilitation and physiotherapists in the pulmonary rehabilitation process that post-SARS-CoV-2 patients must undergo. We enrolled 80 patients in a prospective case-control study; 40 cases (mild-to-moderate post-SARS-CoV-2 infection patients) and 38 control subjects (i.e., patients affected by other respiratory diseases) completed the same full pulmonary rehabilitation cycle. 6-minute walking distance, Borg category-ratio 10 scale, modified Medical Research Council (mMRC) dyspnea scale, European quality of life 5-dimensions-3-level (EuroQoL EQ-5D-3L) questionnaire, Barthel scale, arterial blood gas test, and peripheral oxygen saturation were compared for all patients before and after rehabilitation. All patients experienced significant improvements in all parameters analyzed, except for the arterial blood gas test. Results were similar for both groups; in particular, both groups experienced improvements in the mMRC scale, EuroQoL EQ-5D-3L questionnaire, Barthel scale, and 6-minute walking distance. Pulmonary rehabilitation appears to improve exercise tolerance, dyspnea, and quality of life in patients recovering from a mild-to-moderate SARS-CoV-2 infection. Further studies are needed on a larger sample size population to validate these results.
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Affiliation(s)
- Guido Levi
- Pulmonology Department, ASST Spedali Civili, Brescia; Department of Clinical and Experimental Sciences, University of Brescia.
| | - Marco Umberto Scaramozzino
- Thoracic Endoscopy Service, Tirrenia Hospital, Belvedere Marittimo, Cosenza; "La Madonnina" Hospital, Reggio Calabria.
| | | | | | - Michela Bezzi
- Pulmonology Department, ASST Spedali Civili, Brescia.
| | - Laura Pini
- Department of Clinical and Experimental Sciences, University of Brescia.
| | - Frank Nania
- ASD Planet Sport Gymnasium, Rizziconi, Reggio Calabria.
| | - Sheenam Sheenam
- Department of General Internal Medicine, United Lincolnshire Hospitals NHS Trust, Lincoln.
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13
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Radovanovic D, D'Angelo E. Lung pathophysiology in patients with long COVID-19: one size definitely does not fit all. ERJ Open Res 2023; 9:00052-2023. [PMID: 37077548 PMCID: PMC10107065 DOI: 10.1183/23120541.00052-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 01/26/2023] [Indexed: 04/21/2023] Open
Abstract
Despite reduced resting lung volumes and D LCO, patients with long COVID and dyspnoea have similar physiological response to exercise to healthy subjects. D LCO impairment can marginally explain heterogeneity of complex syndromes such as long COVID. https://bit.ly/40j4aX6.
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Affiliation(s)
- Dejan Radovanovic
- Division of Respiratory Diseases, Department of Biomedical and Clinical Sciences (DIBIC), Ospedale Luigi Sacco, Polo Universitario, ASST Fatebenefratelli-Sacco, Università Degli Studi di Milano, Milan, Italy
- Corresponding author: Dejan Radovanovic ()
| | - Edgardo D'Angelo
- Department of Physiopathology and Transplantation, Università degli Studi di Milano, Milan, Italy
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