Особенности течения хронической обструктивной болезни легких у пациентов, перенесших COVID-19

Abstract

Aim. To evaluate the course of chronic obstructive pulmonary disease (COPD) in patients who had SARS-CoV-2 infection of various severity. Design. Three-centre cross-sectional study under the STROBE standard (STrengthening the Reporting of OBservational studies in Epidemiology). Materials and methods. We conducted a complete medical examination of 46 patients with COPD who had COVID-19 during the past year: without viral damage to pulmonary tissue (CT 0, n = 18), with viral damage to pulmonary tissue of max. 50 % (CT 1–2, n = 24) and with viral damage to pulmonary tissue of at least 50 % (CT 3–4, n = 4). Examinations included analysis of clinical information, laboratory and functional tests, as well as assessment of physical and emotional condition of patients using questionnaires and scales. Results. After the novel coronavirus infection (NCI), 69.6 % of patients developed COPD complications, 26.1 % of patients presented with COPD symptoms for the first time, which required medical assistance. Disease exacerbation was observed approximately 24 weeks after COVID-19. Post-COVID-19 patients required intensification of baseline therapy. COPD patients who had NCI with viral pulmonary involvement had elevated D-dimer levels; CT 3–4 group also had significant impairment of diffusive capacity of lungs. Patients with pulmonary involvement, corresponding to CT 3–4, had statistically higher (p < 0.001) risk of reduction in the quality of life and aggravated anxiety and depression. Conclusion. In post-COVID-19 period, patients with COPD are at high risk of disease exacerbation requiring review of outpatient COPD baseline therapy in post-COVID-19-patients. COPD patients who had mild SARS-CoV-2 require long-term monitoring of their coagulation profile and diffusive capacity of lungs and are recommended long-term psychological support. Keywords: COPD, COVID-19, post-COVID, body plethysmography, diffusive capacity of lungs.