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Gochicoa-Rangel L, Arce SC, Aguirre-Franco C, Madrid-Mejía W, Gutiérrez-Clavería M, Noriega-Aguirre L, Schonffeldt-Guerrero P, Acuña-Izcaray A, Cortés-Telles A, Martínez-Valdeavellano L, Hernández-Rocha FI, Ceballos-Zúñiga O, Del Rio Hidalgo R, Sánchez S, Meneses-Tamayo E, Chérrez-Ojeda I. Effect of Altitude on Respiratory Functional Status in COVID-19 Survivors: Results from a Latin American Cohort-FIRCOV. High Alt Med Biol 2023; 24:37-48. [PMID: 36757307 DOI: 10.1089/ham.2022.0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
Abstract
Laura Gochicoa-Rangel, Santiago C. Arce, Carlos Aguirre-Franco, Wilmer Madrid-Mejía, Mónica Gutiérrez-Clavería, Lorena Noriega-Aguirre, Patricia Schonffeldt-Guerrero, Agustín Acuña-Izcaray, Arturo Cortés-Telles, Luisa Martínez-Valdeavellano, Federico Isaac Hernández-Rocha, Omar Ceballos-Zúñiga, Rodrigo Del Rio Hidalgo, Sonia Sánchez, Erika Meneses-Tamayo, and Iván Chérrez-Ojeda; and on Behalf of the Respiratory Physiology Project in COVID-19 (FIRCOV). Effect of altitude on respiratory functional status in COVID-19 survivors: results from a Latin American Cohort-FIRCOV. High Alt Med Biol 24:37-48, 2023. Persistent symptoms and lung function abnormalities are common in COVID-19 survivors. Objectives: To determine the effect of altitude and other independent variables on respiratory function in COVID-19 survivors. Methods: Analytical, observational, cross-sectional cohort study done at 13 medical centers in Latin America located at different altitudes above sea level. COVID-19 survivors were invited to perform pulmonary function tests at least 3 weeks after diagnosis. Results: 1,368 participants (59% male) had mild (20%), moderate (59%), and severe (21%) disease. Restriction by spirometry was noted in 32%; diffusing capacity of the lung for carbon monoxide (DLCO) was low in 43.7%; and 22.2% walked less meters during the 6-minute walk test (6-MWT). In multiple linear regression models, higher altitude was associated with better spirometry, DLCO and 6-MWT, but lower oxygen saturation at rest and during exercise. Men were 3 times more likely to have restriction and 5.7 times more likely to have a low DLCO. Those who had required mechanical ventilation had lower DLCO and walked less during the 6-MWT. Conclusions: Men were more likely to have lower lung function than women, even after correcting for disease severity and other factors. Patients living at a higher altitude were more likely to have better spirometric patterns and walked farther but had lower DLCO and oxygen saturation.
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Affiliation(s)
- Laura Gochicoa-Rangel
- Departamento de Fisiología Respiratoria, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas," Ciudad de México, México
| | - Santiago C Arce
- Pulmonary Function Laboratory, Instituto de Investigaciones Médicas A. Lanari, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Carlos Aguirre-Franco
- Servicio de Pruebas de Función Pulmonar, Fundación Neumológica Colombiana, Bogotá, Colombia
| | - Wilmer Madrid-Mejía
- Departamento de Fisiología Respiratoria, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas," Ciudad de México, México
| | | | - Lorena Noriega-Aguirre
- Centro de Diagnóstico y Tratamiento de Enfermedades Respiratorias CEDITER, Cd. De Panamá, Panamá
| | | | - Agustín Acuña-Izcaray
- Servicio de Neumonología, Centro Médico Docente La Trinidad y Hospital Universitario de Caracas, Universidad Central de Venezuela, Caracas, Venezuela
| | - Arturo Cortés-Telles
- Clínica de Enfermedades Respiratorias, HRAE de la Península de Yucatán, Mérida, México
| | | | | | | | | | - Sonia Sánchez
- Centro de Estudios Respiratorios, Asunción, Paraguay
| | - Erika Meneses-Tamayo
- Departamento de Fisiología Respiratoria, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas," Ciudad de México, México
| | - Iván Chérrez-Ojeda
- Universidad de Especialidades Espíritu Santo, Samborondón, Ecuador
- Respiralab Research Center, Guayaquil, Ecuador
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Gochicoa-Rangel L, Hernández-Morales AP, Salles-Rojas A, Madrid-Mejía W, Guzmán-Valderrábano C, González-Molina A, Salas-Escamilla I, Durán-Cuellar A, Silva-Cerón M, Hernández-Morales V, Reyes-García A, Alvarado-Amador I, Lozano-Martínez L, Enright P, Pensado-Piedra LE, Torre-Bouscoulet L. Gas Exchange Impairment During COVID-19 Recovery. Respir Care 2021; 66:1610-1617. [PMID: 34465571 PMCID: PMC9993571 DOI: 10.4187/respcare.09114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Persistent impairment of pulmonary function and exercise capacity has been known to last for months or even years in the survivors who recovered from other coronavirus pneumonia. Some reports showed that subjects with coronavirus disease 2019 pneumonia after being discharged could have several sequelae, but there are few studies on gas exchange and exercise capacity complications in these subjects. AIMS To describe residual gas exchange abnormalities during recovery from coronavirus disease 2019 pneumonia. METHODS In an observational study, ∼90 d after onset of disease, we scheduled almost 200 subjects for an out-patient visit with pulmonary function testing and computed tomography of the lungs. Lung mechanics by using body plethysmography, gas exchange with diffusing lung capacity for carbon monoxide determined by the single-breath technique (DLCOsb) and diffusing lung capacity for nitric oxide determined by the single-breath technique (DLNOsb), and exercise ability by using the 6-min walk test (6MWT) were measured in the subjects. The results were compared between those who required invasive mechanical ventilation and those who did not. RESULTS A total of 171 subjects were included, the majority (96%) had signs of residual pneumonia (such as an excess of high attenuation areas) on computed tomography of the lungs. The DLCOSB results were below the lower limit of the normal range in 29.2% of the subjects; during the 6MWT, 67% experienced oxygen desaturation ([Formula: see text]) > 4%; and, in 81 (47%), the dropped below 88%. Subjects who required invasive mechanical ventilation (49.7%) were more likely to have lower lung volumes, more gas exchange abnormality, less exercise capacity and more radiologic abnormality. CONCLUSIONS Subjects who recovered from severe COVID-19 pneumonia continued to have abnormal lung function and abnormal radiologic findings.
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Affiliation(s)
- Laura Gochicoa-Rangel
- Department of Respiratory Physiology, National Institute of Respiratory Diseases "Ismael Cosío Villegas," Mexico City, Mexico.
| | | | - Antonio Salles-Rojas
- Department of Respiratory Physiology, National Institute of Respiratory Diseases "Ismael Cosío Villegas," Mexico City, Mexico
| | - Wilmer Madrid-Mejía
- Department of Respiratory Physiology, National Institute of Respiratory Diseases "Ismael Cosío Villegas," Mexico City, Mexico
| | - Carlos Guzmán-Valderrábano
- Department of Respiratory Physiology, National Institute of Respiratory Diseases "Ismael Cosío Villegas," Mexico City, Mexico
| | - Amaury González-Molina
- Department of Respiratory Physiology, National Institute of Respiratory Diseases "Ismael Cosío Villegas," Mexico City, Mexico
| | - Isabel Salas-Escamilla
- Department of Respiratory Physiology, National Institute of Respiratory Diseases "Ismael Cosío Villegas," Mexico City, Mexico
| | - Adela Durán-Cuellar
- Department of Respiratory Physiology, National Institute of Respiratory Diseases "Ismael Cosío Villegas," Mexico City, Mexico
| | - Mónica Silva-Cerón
- Department of Respiratory Physiology, National Institute of Respiratory Diseases "Ismael Cosío Villegas," Mexico City, Mexico
| | - Víctor Hernández-Morales
- Department of Respiratory Physiology, National Institute of Respiratory Diseases "Ismael Cosío Villegas," Mexico City, Mexico
| | - Alejandro Reyes-García
- Department of Respiratory Physiology, National Institute of Respiratory Diseases "Ismael Cosío Villegas," Mexico City, Mexico
| | - Irlanda Alvarado-Amador
- Department of Respiratory Physiology, National Institute of Respiratory Diseases "Ismael Cosío Villegas," Mexico City, Mexico
| | - Luis Lozano-Martínez
- Department of Respiratory Physiology, National Institute of Respiratory Diseases "Ismael Cosío Villegas," Mexico City, Mexico
| | - Paul Enright
- Pulmonary Function Test Laboratory, Institute for Development and Innovation in Respiratory Physiology, Mexico City, Mexico
| | - Lya Edith Pensado-Piedra
- Department of Image, National Institute of Respiratory Diseases "Ismael Cosío Villegas," Mexico City, Mexico
| | - Luis Torre-Bouscoulet
- Pulmonary Function Test Laboratory, Institute for Development and Innovation in Respiratory Physiology, Mexico City, Mexico
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Madrid-Mejía W, Gochicoa-Rangel L, Padilla JRP, Salles-Rojas A, González-Molina A, Salas-Escamilla I, Durán-Cuellar A, Silva-Cerón M, Guzmán-Valderrábano C, Lozano-Martínez L. Improvement in Walking Distance Lags Raise in Lung Function in Post-COVID Patients. Arch Bronconeumol 2021; 58:261-263. [PMID: 34054195 PMCID: PMC8150358 DOI: 10.1016/j.arbres.2021.04.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/22/2021] [Accepted: 04/26/2021] [Indexed: 12/15/2022]
Key Words
- 6-MWD, 6-minute walk distance
- 6-MWT, 6-minute walk test
- COVID-19, coronavirus disease-2019
- DLCO, diffusing lung capacity for carbon monoxide
- FEV1, forced expiratory volume in the first second
- FT, pulmonary function tests
- FVC, forced vital capacity
- HHR, heart rate recovery
- IMV, invasive mechanical ventilation
- LLN, lower limit of normal
- MEP, maximal expiratory pressure
- MERS, Middle East respiratory syndrome
- MIP, maximal inspiratory pressure
- SARS, severe acute respiratory syndrome
- SpO2, oxygen blood saturation measured by pulse oximeter
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Affiliation(s)
- Wilmer Madrid-Mejía
- Department of Respiratory Physiology. National Institute of Respiratory Diseases "Ismael Cosío Villegas", Mexico City, Mexico
| | - Laura Gochicoa-Rangel
- Department of Respiratory Physiology. National Institute of Respiratory Diseases "Ismael Cosío Villegas", Mexico City, Mexico
| | - José Rogelio Pérez Padilla
- COPD and Tobacco Research Department. National Institute of Respiratory Diseases "Ismael Cosío Villegas", Mexico City, Mexico
| | - Antonio Salles-Rojas
- Department of Respiratory Physiology. National Institute of Respiratory Diseases "Ismael Cosío Villegas", Mexico City, Mexico
| | - Amaury González-Molina
- Department of Respiratory Physiology. National Institute of Respiratory Diseases "Ismael Cosío Villegas", Mexico City, Mexico
| | - Isabel Salas-Escamilla
- Department of Respiratory Physiology. National Institute of Respiratory Diseases "Ismael Cosío Villegas", Mexico City, Mexico
| | - Adela Durán-Cuellar
- Department of Respiratory Physiology. National Institute of Respiratory Diseases "Ismael Cosío Villegas", Mexico City, Mexico
| | - Mónica Silva-Cerón
- Department of Respiratory Physiology. National Institute of Respiratory Diseases "Ismael Cosío Villegas", Mexico City, Mexico
| | - Carlos Guzmán-Valderrábano
- Department of Respiratory Physiology. National Institute of Respiratory Diseases "Ismael Cosío Villegas", Mexico City, Mexico
| | - Luis Lozano-Martínez
- Department of Respiratory Physiology. National Institute of Respiratory Diseases "Ismael Cosío Villegas", Mexico City, Mexico
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Gochicoa-Rangel L, Torre-Bouscoulet L, Salles Rojas A, Guzmán-Valderrábano C, Silva-Cerón M, Benítez-Pérez RE, Salas-Escamilla I, Madrid-Mejía W, Grosso-Espinosa JM. Functional Respiratory Evaluation in the COVID-19 Era: The Role of Pulmonary Function Test Laboratories. Rev Invest Clin 2020; 73. [PMID: 33053579 DOI: 10.24875/ric.20000250] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 06/01/2020] [Indexed: 11/17/2022]
Abstract
The pandemic character of coronavirus disease-19 (COVID-19) requires strategy changes designed to guarantee the safety of patients and health-care professionals. We are greatly concerned by the limitations in the operation of pulmonary function test (PFT) laboratories, since there is a high risk of disease progression in patients with chronic pulmonary diseases, and we are now faced by the influx of a new group of individuals in the recovery phase of post-COVID-19-syndrome that requires evaluation and follow-up of their respiratory function. To reestablish the operation of PFT laboratories limiting the risk of cross-contamination, we herein present the consensus reached by a group of experts in respiratory physiology, most of whom work in PFT laboratories in several Latin American countries, on the applicable recommendations for severe acute respiratory syndrome coronavirus 2 pneumonia survivors when undergoing PFT. We present the safety and hygiene measures that must be adopted in laboratories or centers where PFT is conducted in adults and/or children. These recommendations answer the following questions: which PFT is most recommended in subjects that have recovered from COVID-19; what quality control and safety measures should PFT laboratories implement during this pandemic? And how should we approach non-COVID-19 patients requiring PFT?
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Affiliation(s)
- Laura Gochicoa-Rangel
- Department of Respiratory Physiology, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Mexico City, Mexico
| | - Luis Torre-Bouscoulet
- Laboratory of Pulmonary Function Tests, Instituto de Desarrollo e Innovación en Fisiología Respiratoria, Mexico City, Mexico
| | - Antonio Salles Rojas
- Department of Respiratory Physiology, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Mexico City, Mexico
| | - Carlos Guzmán-Valderrábano
- Department of Respiratory Physiology, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Mexico City, Mexico
| | - Mónica Silva-Cerón
- Department of Respiratory Physiology, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Mexico City, Mexico
| | - Rosaura E Benítez-Pérez
- Department of Continuous Education, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Mexico City, Mexico
| | - Isabel Salas-Escamilla
- Department of Respiratory Physiology, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Mexico City, Mexico
| | - Wilmer Madrid-Mejía
- Department of Respiratory Physiology, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Mexico City, Mexico
| | - Juan M Grosso-Espinosa
- Laboratory of Pulmonary Function Tests, Instituto de Desarrollo e Innovación en Fisiología Respiratoria, Mexico City, Mexico
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