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Sperling S, Fløe A, Leth S, Hyldgaard C, Gissel T, Topcu A, Kristensen L, Sønderskov LD, Schmid JM, Jensen-Fangel S, Bendstrup E. Fatigue Is a Major Symptom at COVID-19 Hospitalization Follow-Up. J Clin Med 2022; 11:jcm11092411. [PMID: 35566536 PMCID: PMC9106038 DOI: 10.3390/jcm11092411] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/23/2022] [Accepted: 04/24/2022] [Indexed: 12/23/2022] Open
Abstract
Persistent symptoms after hospitalization with COVID-19 are common, but the frequency and severity of these symptoms are insufficiently understood. We aimed to describe symptoms and pulmonary function after hospitalization with COVID-19. Patients hospitalized with COVID-19 in Central Denmark Region were invited for follow-up 3 months after discharge. Clinical characteristics, patient reported outcomes (Fatigue Assessment Scale (FAS), anxiety and depression (HADS)), symptoms, pulmonary function test and 6-min walk test were collected. We included 218 patients (mean age 59.9 (95% CI: 58.2, 61.7), 59% males). Fatigue, dyspnea and impaired concentration were the most prevalent symptoms at follow-up. Using FAS, 47% reported mild-to-moderate fatigue and 18% severe fatigue. Mean HADS was 7.9 (95% CI: 6.9, 8.9). FAS was correlated to HADS (β = 0.52 (95% CI: 0.44, 0.59, p < 0.001)). Mean DLCO was 80.4% (95% CI: 77.8, 83.0) and 45% had DLCO ˂ 80%. Mean DLCO was significantly reduced in patients treated in the ICU (70.46% (95% CI 65.13, 75.79)). The highest FAS and HADS were seen in patients with the shortest period of hospitalization (2.1 days (95% CI: 1.4, 2.7)) with no need for oxygen. In conclusion, fatigue is a common symptom after hospitalization for COVID-19 and ICU treatment is associated to decreased diffusion capacity.
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Affiliation(s)
- Søren Sperling
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, 8200 Aarhus, Denmark; (A.F.); (J.M.S.); (E.B.)
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus, Denmark; (S.L.); (S.J.-F.)
- Correspondence: ; Tel.: +45-7846-2106
| | - Andreas Fløe
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, 8200 Aarhus, Denmark; (A.F.); (J.M.S.); (E.B.)
| | - Steffen Leth
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus, Denmark; (S.L.); (S.J.-F.)
- Department of Infectious Diseases, Regional Hospital West Jutland, 7400 Goedstrup, Denmark
- Department of Infectious Diseases, Aarhus University Hospital, 8200 Aarhus, Denmark
| | | | - Tina Gissel
- Department of Respiratory Diseases, Viborg Regional Hospital, 8800 Viborg, Denmark;
| | - Ayfer Topcu
- Department of Respiratory Diseases, Horsens Regional Hospital, 8700 Horsens, Denmark;
| | - Lars Kristensen
- Department of Respiratory Diseases, Regional Hospital West Jutland, 7400 Goedstrup, Denmark;
| | - Lene Dahl Sønderskov
- Department of Respiratory Diseases, Randers Regional Hospital, 8900 Randers, Denmark;
| | - Johannes Martin Schmid
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, 8200 Aarhus, Denmark; (A.F.); (J.M.S.); (E.B.)
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus, Denmark; (S.L.); (S.J.-F.)
| | - Søren Jensen-Fangel
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus, Denmark; (S.L.); (S.J.-F.)
- Department of Infectious Diseases, Aarhus University Hospital, 8200 Aarhus, Denmark
| | - Elisabeth Bendstrup
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, 8200 Aarhus, Denmark; (A.F.); (J.M.S.); (E.B.)
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus, Denmark; (S.L.); (S.J.-F.)
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Andersen CU, Sønderskov LD, Bendstrup E, Voldby N, Cass L, Ayrton J, Hilberg O. Voriconazole Concentrations in Plasma and Epithelial Lining Fluid after Inhalation and Oral Treatment. Basic Clin Pharmacol Toxicol 2017; 121:430-434. [PMID: 28609608 DOI: 10.1111/bcpt.12820] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 05/22/2017] [Indexed: 11/30/2022]
Abstract
Adverse effects can compromise oral voriconazole treatment of pulmonary aspergillosis. Inhaled low-dose voriconazole may be an alternative treatment. In this study, six patients inhaled 40 mg voriconazole b.i.d. for 2 days, and six patients ingested 400 and 200 mg orally b.i.d. on day one and two, respectively. Blood samples were collected after the first inhalation, and bronchial alveolar lavage fluids and blood samples were collected for measurements of voriconazole 12 hr after the last administration. The concentration of voriconazole in epithelial lining fluid (ELF) was calculated by the urea dilution method. Voriconazole concentrations were detectable in plasma 15 min. after inhalation and declined at 30 and 60 min. Twelve hours after the last dose, median (95% CI) plasma voriconazole concentration was 8 (4-26) ng/mL in the inhalation group and 1224 (535-2341) ng/mL in the oral group (p < 0.0001). In ELF, median concentration was 190 (55-318) ng/mL and 8827 (4369-35172) ng/mL, respectively (p < 0.0001). Median ELF/plasma concentration ratio was 21 (6-63) in the inhalation group and 8 (3-20) in the oral group (p = 0.2). In conclusion, voriconazole is rapidly absorbed into the systemic circulation after inhalation. There was a non-significant trend towards a higher ELF/plasma concentration ratio in the inhalation group compared to the oral group.
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Affiliation(s)
- Charlotte U Andersen
- Department of Clinical Pharmacology, Aalborg and Aarhus University Hospital, Aarhus C, Denmark
| | - Lene Dahl Sønderskov
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus C, Denmark
| | - Elisabeth Bendstrup
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus C, Denmark
| | - Nina Voldby
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus C, Denmark
| | | | | | - Ole Hilberg
- Medical Department, Vejle Hospital, Vejle, Denmark
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Uggerhøj Andersen C, Sønderskov LD, Nielsen-Kudsk JE, Simonsen U, Bendstrup E, Hilberg O, Mellemkjær S. [Pulmonary hypertension--classification, work-up and treatment]. Ugeskr Laeger 2013; 175:1642-1645. [PMID: 23731992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Pulmonary hypertension (PH) is classified into five groups. It is an important cause of dyspnoea. Echocardiography is the best non-invasive method for detecting PH and should be part of the evaluation of patients with dyspnoea. If signs of PH are detected on echocardiography, a number of other examinations should be undertaken to verify the diagnosis and classify PH correctly, as the treatment depends on the subtype of PH. The prognosis of PH is poor, but early detection and treatment can improve the course for some of the patients. Surgery can often cure chronic thromboembolic pulmonary hypertension.
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