Dyspnea in Post-Acute COVID-19: A Multi-Parametric Cardiopulmonary Evaluation
Post-acute COVID-19 is characterized by the persistence of dyspnea, but the pathophysiology is unclear. We evaluated the prevalence of dyspnea during follow-up and factors at admission and follow-up associated with dyspnea persistence. After five months from discharge, 225 consecutive patients hospi...
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| Veröffentlicht in: | Journal of clinical medicine 2023-07, Vol.12 (14), p.4658 |
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| creator | Cecchetto, Antonella Guarnieri, Gabriella Torreggiani, Gianpaolo Vianello, Andrea Baroni, Giulia Palermo, Chiara Bertagna De Marchi, Leonardo Lorenzoni, Giulia Bartolotta, Patrizia Bertaglia, Emanuele Donato, Filippo Aruta, Patrizia Iliceto, Sabino Mele, Donato |
| description | Post-acute COVID-19 is characterized by the persistence of dyspnea, but the pathophysiology is unclear. We evaluated the prevalence of dyspnea during follow-up and factors at admission and follow-up associated with dyspnea persistence. After five months from discharge, 225 consecutive patients hospitalized for moderate to severe COVID-19 pneumonia were assessed clinically and by laboratory tests, echocardiography, six-minute walking test (6MWT), and pulmonary function tests. Fifty-one patients reported persistent dyspnea. C-reactive protein (
= 0.025, OR 1.01 (95% CI 1.00-1.02)) at admission, longer duration of hospitalization (
= 0.005, OR 1.05 (95% CI 1.01-1.10)) and higher body mass index (
= 0.001, OR 1.15 (95% CI 1.06-1.28)) were independent predictors of dyspnea. Absolute drop in SpO
at 6MWT (
= 0.001, OR 1.37 (95% CI 1.13-1.69)), right ventricular (RV) global longitudinal strain (
= 0.016, OR 1.12 (95% CI 1.02-1.25)) and RV global longitudinal strain/systolic pulmonary artery pressure ratio (
= 0.034, OR 0.14 (95% CI 0.02-0.86)) were independently associated with post-acute COVID-19 dyspnea. In conclusion, dyspnea is present in many patients during follow-up after hospitalization for COVID-19 pneumonia. While higher body mass index, C-reactive protein at admission, and duration of hospitalization are predictors of persistent dyspnea, desaturation at 6MWT, and echocardiographic RV dysfunction are associated with this symptom during the follow-up period. |
| doi_str_mv | 10.3390/jcm12144658 |
| format | Article |
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= 0.025, OR 1.01 (95% CI 1.00-1.02)) at admission, longer duration of hospitalization (
= 0.005, OR 1.05 (95% CI 1.01-1.10)) and higher body mass index (
= 0.001, OR 1.15 (95% CI 1.06-1.28)) were independent predictors of dyspnea. Absolute drop in SpO
at 6MWT (
= 0.001, OR 1.37 (95% CI 1.13-1.69)), right ventricular (RV) global longitudinal strain (
= 0.016, OR 1.12 (95% CI 1.02-1.25)) and RV global longitudinal strain/systolic pulmonary artery pressure ratio (
= 0.034, OR 0.14 (95% CI 0.02-0.86)) were independently associated with post-acute COVID-19 dyspnea. In conclusion, dyspnea is present in many patients during follow-up after hospitalization for COVID-19 pneumonia. While higher body mass index, C-reactive protein at admission, and duration of hospitalization are predictors of persistent dyspnea, desaturation at 6MWT, and echocardiographic RV dysfunction are associated with this symptom during the follow-up period.</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm12144658</identifier><identifier>PMID: 37510773</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Biomarkers ; Carbon monoxide ; Causes of ; Clinical medicine ; COVID-19 ; Development and progression ; Diagnosis ; Dyspnea ; Flow velocity ; Hospitalization ; Hospitals ; Infections ; Medical research ; Patients ; Pneumonia ; Pulmonary arteries ; Quality of life ; Shortness of breath ; Software ; Statistical analysis ; Ultrasonic imaging ; Ventilators ; Walking</subject><ispartof>Journal of clinical medicine, 2023-07, Vol.12 (14), p.4658</ispartof><rights>COPYRIGHT 2023 MDPI AG</rights><rights>2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 by the authors. 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c477t-7bc141c01b589b198492d9b8cf44ab54ed612f70912404a3ad5753b0106759ed3</citedby><cites>FETCH-LOGICAL-c477t-7bc141c01b589b198492d9b8cf44ab54ed612f70912404a3ad5753b0106759ed3</cites><orcidid>0000-0002-8790-6029 ; 0000-0003-1771-4686 ; 0000-0002-2823-4090 ; 0000-0003-4069-4177 ; 0000-0001-6445-5280 ; 0000-0003-3389-5835 ; 0000-0001-9779-8298</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10380208/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10380208/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37510773$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cecchetto, Antonella</creatorcontrib><creatorcontrib>Guarnieri, Gabriella</creatorcontrib><creatorcontrib>Torreggiani, Gianpaolo</creatorcontrib><creatorcontrib>Vianello, Andrea</creatorcontrib><creatorcontrib>Baroni, Giulia</creatorcontrib><creatorcontrib>Palermo, Chiara</creatorcontrib><creatorcontrib>Bertagna De Marchi, Leonardo</creatorcontrib><creatorcontrib>Lorenzoni, Giulia</creatorcontrib><creatorcontrib>Bartolotta, Patrizia</creatorcontrib><creatorcontrib>Bertaglia, Emanuele</creatorcontrib><creatorcontrib>Donato, Filippo</creatorcontrib><creatorcontrib>Aruta, Patrizia</creatorcontrib><creatorcontrib>Iliceto, Sabino</creatorcontrib><creatorcontrib>Mele, Donato</creatorcontrib><title>Dyspnea in Post-Acute COVID-19: A Multi-Parametric Cardiopulmonary Evaluation</title><title>Journal of clinical medicine</title><addtitle>J Clin Med</addtitle><description>Post-acute COVID-19 is characterized by the persistence of dyspnea, but the pathophysiology is unclear. We evaluated the prevalence of dyspnea during follow-up and factors at admission and follow-up associated with dyspnea persistence. After five months from discharge, 225 consecutive patients hospitalized for moderate to severe COVID-19 pneumonia were assessed clinically and by laboratory tests, echocardiography, six-minute walking test (6MWT), and pulmonary function tests. Fifty-one patients reported persistent dyspnea. C-reactive protein (
= 0.025, OR 1.01 (95% CI 1.00-1.02)) at admission, longer duration of hospitalization (
= 0.005, OR 1.05 (95% CI 1.01-1.10)) and higher body mass index (
= 0.001, OR 1.15 (95% CI 1.06-1.28)) were independent predictors of dyspnea. Absolute drop in SpO
at 6MWT (
= 0.001, OR 1.37 (95% CI 1.13-1.69)), right ventricular (RV) global longitudinal strain (
= 0.016, OR 1.12 (95% CI 1.02-1.25)) and RV global longitudinal strain/systolic pulmonary artery pressure ratio (
= 0.034, OR 0.14 (95% CI 0.02-0.86)) were independently associated with post-acute COVID-19 dyspnea. In conclusion, dyspnea is present in many patients during follow-up after hospitalization for COVID-19 pneumonia. While higher body mass index, C-reactive protein at admission, and duration of hospitalization are predictors of persistent dyspnea, desaturation at 6MWT, and echocardiographic RV dysfunction are associated with this symptom during the follow-up period.</description><subject>Biomarkers</subject><subject>Carbon monoxide</subject><subject>Causes of</subject><subject>Clinical medicine</subject><subject>COVID-19</subject><subject>Development and progression</subject><subject>Diagnosis</subject><subject>Dyspnea</subject><subject>Flow velocity</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Infections</subject><subject>Medical research</subject><subject>Patients</subject><subject>Pneumonia</subject><subject>Pulmonary arteries</subject><subject>Quality of life</subject><subject>Shortness of breath</subject><subject>Software</subject><subject>Statistical analysis</subject><subject>Ultrasonic imaging</subject><subject>Ventilators</subject><subject>Walking</subject><issn>2077-0383</issn><issn>2077-0383</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNptks9LHTEQx0OxVLGeei8LvQiyNpMfm6QXebxnW0HRQ9tryGazNo_d5JnsCv735qG1z9LkkCHzmW9mJoPQB8CnlCr8eW1HIMBYw-UbdECwEDWmku7t2PvoKOc1LktKRkC8Q_tUcChueoCuVg95E5ypfKhuYp7qhZ0nVy2vf12salBfqkV1NQ-Tr29MMqObkrfV0qTOx808jDGY9FCd35thNpOP4T1625shu6Pn8xD9_Hr-Y_m9vrz-drFcXNaWCTHVorXAwGJouVQtKMkU6VQrbc-YaTlzXQOkF1gBYZgZajouOG0x4EZw5Tp6iM6edDdzO7rOujAlM-hN8mNJSEfj9WtP8L_1bbzXUBqCCZZF4fhZIcW72eVJjz5bNwwmuDhnTSRjWOFGkYJ--gddxzmFUt-WoqWPvIG_1K0ZnPahj-VhuxXVi5I0cNoQXKjT_1Bld270NgbX-3L_KuDkKcCmmHNy_UuRgPV2AvTOBBT6425fXtg__00fAXZcp8k</recordid><startdate>20230713</startdate><enddate>20230713</enddate><creator>Cecchetto, Antonella</creator><creator>Guarnieri, Gabriella</creator><creator>Torreggiani, Gianpaolo</creator><creator>Vianello, Andrea</creator><creator>Baroni, Giulia</creator><creator>Palermo, Chiara</creator><creator>Bertagna De Marchi, Leonardo</creator><creator>Lorenzoni, Giulia</creator><creator>Bartolotta, Patrizia</creator><creator>Bertaglia, Emanuele</creator><creator>Donato, Filippo</creator><creator>Aruta, Patrizia</creator><creator>Iliceto, Sabino</creator><creator>Mele, Donato</creator><general>MDPI AG</general><general>MDPI</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-8790-6029</orcidid><orcidid>https://orcid.org/0000-0003-1771-4686</orcidid><orcidid>https://orcid.org/0000-0002-2823-4090</orcidid><orcidid>https://orcid.org/0000-0003-4069-4177</orcidid><orcidid>https://orcid.org/0000-0001-6445-5280</orcidid><orcidid>https://orcid.org/0000-0003-3389-5835</orcidid><orcidid>https://orcid.org/0000-0001-9779-8298</orcidid></search><sort><creationdate>20230713</creationdate><title>Dyspnea in Post-Acute COVID-19: A Multi-Parametric Cardiopulmonary Evaluation</title><author>Cecchetto, Antonella ; Guarnieri, Gabriella ; Torreggiani, Gianpaolo ; Vianello, Andrea ; Baroni, Giulia ; Palermo, Chiara ; Bertagna De Marchi, Leonardo ; Lorenzoni, Giulia ; Bartolotta, Patrizia ; Bertaglia, Emanuele ; Donato, Filippo ; Aruta, Patrizia ; Iliceto, Sabino ; Mele, Donato</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c477t-7bc141c01b589b198492d9b8cf44ab54ed612f70912404a3ad5753b0106759ed3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Biomarkers</topic><topic>Carbon monoxide</topic><topic>Causes of</topic><topic>Clinical medicine</topic><topic>COVID-19</topic><topic>Development and progression</topic><topic>Diagnosis</topic><topic>Dyspnea</topic><topic>Flow velocity</topic><topic>Hospitalization</topic><topic>Hospitals</topic><topic>Infections</topic><topic>Medical research</topic><topic>Patients</topic><topic>Pneumonia</topic><topic>Pulmonary arteries</topic><topic>Quality of life</topic><topic>Shortness of breath</topic><topic>Software</topic><topic>Statistical analysis</topic><topic>Ultrasonic imaging</topic><topic>Ventilators</topic><topic>Walking</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cecchetto, Antonella</creatorcontrib><creatorcontrib>Guarnieri, Gabriella</creatorcontrib><creatorcontrib>Torreggiani, Gianpaolo</creatorcontrib><creatorcontrib>Vianello, Andrea</creatorcontrib><creatorcontrib>Baroni, Giulia</creatorcontrib><creatorcontrib>Palermo, Chiara</creatorcontrib><creatorcontrib>Bertagna De Marchi, Leonardo</creatorcontrib><creatorcontrib>Lorenzoni, Giulia</creatorcontrib><creatorcontrib>Bartolotta, Patrizia</creatorcontrib><creatorcontrib>Bertaglia, Emanuele</creatorcontrib><creatorcontrib>Donato, Filippo</creatorcontrib><creatorcontrib>Aruta, Patrizia</creatorcontrib><creatorcontrib>Iliceto, Sabino</creatorcontrib><creatorcontrib>Mele, Donato</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of clinical medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cecchetto, Antonella</au><au>Guarnieri, Gabriella</au><au>Torreggiani, Gianpaolo</au><au>Vianello, Andrea</au><au>Baroni, Giulia</au><au>Palermo, Chiara</au><au>Bertagna De Marchi, Leonardo</au><au>Lorenzoni, Giulia</au><au>Bartolotta, Patrizia</au><au>Bertaglia, Emanuele</au><au>Donato, Filippo</au><au>Aruta, Patrizia</au><au>Iliceto, Sabino</au><au>Mele, Donato</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Dyspnea in Post-Acute COVID-19: A Multi-Parametric Cardiopulmonary Evaluation</atitle><jtitle>Journal of clinical medicine</jtitle><addtitle>J Clin Med</addtitle><date>2023-07-13</date><risdate>2023</risdate><volume>12</volume><issue>14</issue><spage>4658</spage><pages>4658-</pages><issn>2077-0383</issn><eissn>2077-0383</eissn><abstract>Post-acute COVID-19 is characterized by the persistence of dyspnea, but the pathophysiology is unclear. We evaluated the prevalence of dyspnea during follow-up and factors at admission and follow-up associated with dyspnea persistence. After five months from discharge, 225 consecutive patients hospitalized for moderate to severe COVID-19 pneumonia were assessed clinically and by laboratory tests, echocardiography, six-minute walking test (6MWT), and pulmonary function tests. Fifty-one patients reported persistent dyspnea. C-reactive protein (
= 0.025, OR 1.01 (95% CI 1.00-1.02)) at admission, longer duration of hospitalization (
= 0.005, OR 1.05 (95% CI 1.01-1.10)) and higher body mass index (
= 0.001, OR 1.15 (95% CI 1.06-1.28)) were independent predictors of dyspnea. Absolute drop in SpO
at 6MWT (
= 0.001, OR 1.37 (95% CI 1.13-1.69)), right ventricular (RV) global longitudinal strain (
= 0.016, OR 1.12 (95% CI 1.02-1.25)) and RV global longitudinal strain/systolic pulmonary artery pressure ratio (
= 0.034, OR 0.14 (95% CI 0.02-0.86)) were independently associated with post-acute COVID-19 dyspnea. In conclusion, dyspnea is present in many patients during follow-up after hospitalization for COVID-19 pneumonia. While higher body mass index, C-reactive protein at admission, and duration of hospitalization are predictors of persistent dyspnea, desaturation at 6MWT, and echocardiographic RV dysfunction are associated with this symptom during the follow-up period.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>37510773</pmid><doi>10.3390/jcm12144658</doi><orcidid>https://orcid.org/0000-0002-8790-6029</orcidid><orcidid>https://orcid.org/0000-0003-1771-4686</orcidid><orcidid>https://orcid.org/0000-0002-2823-4090</orcidid><orcidid>https://orcid.org/0000-0003-4069-4177</orcidid><orcidid>https://orcid.org/0000-0001-6445-5280</orcidid><orcidid>https://orcid.org/0000-0003-3389-5835</orcidid><orcidid>https://orcid.org/0000-0001-9779-8298</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MDPI - Multidisciplinary Digital Publishing Institute; EZB-FREE-00999 freely available EZB journals; PubMed Central; PubMed Central Open Access |
| subjects | Biomarkers Carbon monoxide Causes of Clinical medicine COVID-19 Development and progression Diagnosis Dyspnea Flow velocity Hospitalization Hospitals Infections Medical research Patients Pneumonia Pulmonary arteries Quality of life Shortness of breath Software Statistical analysis Ultrasonic imaging Ventilators Walking |
| title | Dyspnea in Post-Acute COVID-19: A Multi-Parametric Cardiopulmonary Evaluation |
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