Abstract
Since SARS-CoV-2 emerged in 2019, strict monitoring of post-COVID-19 patients in order to ensure the early detection of sequelae and/or chronic organ damage that could been associated with the infection has been essential. Potential involvement of the NO pathway in the development of post-COVID-19 lung fibrotic alterations is feasible, since the majority of respiratory cells can produce NO, and fractional exhaled NO (FeNO) represents a biomarker of airway inflammation. The aim of this study was to investigate the potential utility of multiple-flow FeNO parameters in a post-COVID-19 population and to compare it with other indicators of lung damage proposed in the literature. We enrolled 20 patients hospitalized for COVID-19, who underwent clinical, respiratory functional (including PFTs and FeNO) and radiological follow-up after discharge. Compared with age- and sex-matched healthy controls, post-COVID-19 patients showed significantly higher FeNO 350 mL/s and CaNO levels. Moreover, among the parameters included in the follow-up, CaNO showed the best accuracy in indicating predominant fibrotic changes and GGO at CT scan. To our knowledge, this preliminary study has investigated for the first time multiple-flow FeNO parameters in a post-COVID-19 population. The evidence of increased CaNO values may imply the persistence of alveolar and bronchiolar inflammation and/or a mild impairment of the alveolar-capillary membrane in these patients.
Highlights
Since December 2019, severe acute respiratory syndrome coronavirus-2 (SARS-CoV2)-induced infection has spread globally, reaching the status of pandemic in March 2020, as declared by the World Health Organization [1]
Three patients were affected by chronic obstructive pulmonary disease (COPD) and they were all treated with long-acting muscarinic agents (LAMA)
None of the patients included in the study reported a diagnosis of asthma, allergic rhinitis, chronic rhinosinusitis with nasal polyps, bronchiectasis, or underlying interstitial lung diseases, and/or were treated with ICS, oral steroids, or phosphodiesterase5 inhibitors
Summary
Since December 2019, severe acute respiratory syndrome coronavirus-2 (SARS-CoV2)-induced infection has spread globally, reaching the status of pandemic in March 2020, as declared by the World Health Organization [1]. The SARS-CoV-2 pandemic is ongoing and still represents a global health menace, due to its high transmissibility and the risk of inducing severe respiratory failure, caused, for example, by acute respiratory distress syndrome (ARDS). This has severely hindered national health systems over the last 18 months [2]. Since SARS-CoV-2 emerged in 2019, it has become essential to strictly monitor post-COVID-19 patients to ensure early detection of long-term sequelae and chronic organ damage associated with the infection
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