Abstract
BackgroundThousands of people worldwide are suffering the consequences of coronavirus disease-2019 (COVID-19), and impulse oscillometry (IOS) and lung ultrasound (LUS) might be important tools for the follow-up of this population. Our objective was to prospectively evaluate abnormalities detected using these two methods in a cohort of COVID-19 survivors with respiratory symptoms.MethodsIn this follow-up study, 59 patients underwent clinical evaluations, spirometry, IOS and LUS in the 2nd (M1) and 5th (M2) months after diagnostic confirmation of COVID-19 by real-time reverse transcriptase–polymerase chain reaction. Aeration scores were obtained from the LUS exams based on the following findings: B-lines >2, coalescent B-lines, and subpleural consolidations.ResultsFifty-nine (100%) participants had cough and/or dyspnea at M1, which decreased to 38 (64.4%) at M2 (p = 0.0001). Spirometry was abnormal in 26 (44.1%) and 20 (33.9%) participants at M1 and M2, respectively, although without statistical significance (p = 0.10). Normal examination, restrictive patterns, and obstructive patterns were observed in 33 (55.9%), 18 (30.5%), and 8 (13.6%) participants, respectively, at M1 and in 39 (66.1%), 13 (22%), and 7 (11.9%) participants at M2 (p = 0.14). Regarding IOS, considering changes in resistive and reactive parameters, abnormal exams were detected in 52 (88.1%) and 42 (71.2%) participants at M1 and M2, respectively (p = 0.002). Heterogeneity of resistance between 4 and 20 Hz >20% was observed in 38 (64.4%) and 33 (55.9%) participants at M1 and M2, respectively (p = 0.30). Abnormal LUS was observed in 46 (78%) and 36 (61%) participants at M1 and M2, respectively (p = 0.002), with a reduction in aeration scores between M1 and M2 [5 (2–8) vs. 3 (0–6) points, p<0.0001].ConclusionsIOS and LUS abnormalities are frequent in the first 5 months post-COVID-19 infection; however, when prospectively evaluated, significant improvement is evident in the parameters measured by these two methods.
Highlights
The lungs are the organs most affected by coronavirus disease 2019 (COVID-19) [1]
impulse oscillometry (IOS) and lung ultrasound (LUS) abnormalities are frequent in the first 5 months post-COVID-19 infection; when prospectively evaluated, significant improvement is evident in the parameters measured by these two methods
The entry of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) into human cells is facilitated by angiotensin-converting enzyme 2 (ACE2) receptors expressed by type 2 pneumocytes, leading to the release of antiviral cytokines in alveolar septa and the pulmonary interstitium [2]
Summary
The lungs are the organs most affected by coronavirus disease 2019 (COVID-19) [1]. The entry of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) into human cells is facilitated by angiotensin-converting enzyme 2 (ACE2) receptors expressed by type 2 pneumocytes, leading to the release of antiviral cytokines in alveolar septa and the pulmonary interstitium [2]. Computed tomography (CT) of the chest has been widely used to determine the extent of the damage caused by SARS-CoV-2, it is costly, has low availability, and exposes the patient to ionizing radiation, which limits its use in some populations [5]. In this scenario, lung ultrasound (LUS) in the evaluation of patients with COVID-19 has been increasingly used and should be encouraged because it is a practical, low-cost, and radiation-free method, in addition to requiring equipment that is easy to clean [5,6,7]. Our objective was to prospectively evaluate abnormalities detected using these two methods in a cohort of COVID-19 survivors with respiratory symptoms
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