Respiratory disorders of post-COVID-19 syndrome

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Abstract

Aim. Assess the functional state of trespiratory system and effectiveness of therapeutic tactics for broncho-obstructive syndrome (BOS) in patients in the post-COVID period.

Materials and methods. A two-center cohort prospective study included 10 456 and 89 patients, respectively. A comprehensive assessment of the respiratory system included clinical, laboratory and functional data, spirometry, body plethysmography, and a study of diffusive capacity of the lungs (DLCO). Therapy consisted of budesonide suspension or fixed combination beclomethasone dipropionate/formoterol (EMD BDP/FORM).

Results. The frequency of BOS in the cohort was 72% (7497 patients). In 13% (n=974) of cases, bronchial asthma was diagnosed for the first time, in 4.4% (n=328) – chronic obstructive pulmonary disease. Risk factors for the development and decrease in DLCO in the post-COVID period were identified. In the group of complex instrumental examination of lung function, the absence of violations of spirometric data and indicators determined by body plethysmography was determined.

Conclusion. Risk factors for BOS in post-COVID period are atopy, a history of frequent acute respiratory infections, smoking, blood eosinophilia, moderate and severe forms of COVID-19. The advantage of a fixed combination of EMD BDP/FORM in MART mode compared with nebulized suspension budesonide + solution of salbutamol in treatment of BOS was shown. Risk factors for DLCO disorders were established: severe COVID-19, hospitalization in the intensive care unit, the need for additional oxygen therapy.

About the authors

Igor V. Leshchenko

Ural State Medical University; Ural Research Institute of Phthisiopulmonology – branch of the National Medical Research Center for Phthisiopulmonology and Infectious Diseases; LLC “Medical Association “New Hospital”

Author for correspondence.
Email: leshchenkoiv@yandex.ru
ORCID iD: 0000-0002-1620-7159

д-р мед. наук, проф. каф. фтизиатрии и пульмонологии, глав. науч. сотр. Уральского НИИ фтизиопульмонологии, науч. рук. клиники

Russian Federation, Yekaterinburg; Yekaterinburg; Yekaterinburg

Natalia A. Esaulova

Ural State Medical University; Ural Research Institute of Phthisiopulmonology – branch of the National Medical Research Center for Phthisiopulmonology and Infectious Diseases

Email: leshchenkoiv@yandex.ru
ORCID iD: 0000-0001-9565-3570

канд. мед. наук, доц. каф. фтизиатрии и пульмонологии

Russian Federation, Yekaterinburg; Yekaterinburg

Tatyana V. Glushkova

Ural Research Institute of Phthisiopulmonology – branch of the National Medical Research Center for Phthisiopulmonology and Infectious Diseases

Email: leshchenkoiv@yandex.ru
ORCID iD: 0000-0002-5693-5097

врач-пульмонолог

Russian Federation, Yekaterinburg

Sergey N. Skornyakov

Ural State Medical University; Ural Research Institute of Phthisiopulmonology – branch of the National Medical Research Center for Phthisiopulmonology and Infectious Diseases

Email: leshchenkoiv@yandex.ru
ORCID iD: 0000-0002-9942-3008

д-р мед. наук, проф., зав. каф. фтизиатрии и пульмонологии, зав. научно-клиническим отд.

Russian Federation, Yekaterinburg; Yekaterinburg

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Supplementary files

Supplementary Files
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2. Fig. 1. Distribution of patients with newly diagnosed respiratory diseases in the post-COVID period (n=7497).

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3. Fig. 2. Distribution of patients, who underwent COVID-19 of varying severity, diagnosed, depending on the risk factors (n=974).

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4. Fig. 3. Correlation of DLCO levels measured at 12 months from the onset of COVID-19 symptoms and the required Intensive Care Units stay during the acute period of the disease.

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5. Fig. 4. Correlation of DLCO levels measured after 12 months from the onset of COVID-19 symptoms and the required high-flow oxygen therapy in the acute period of disease (p<0.05).

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