Long-Term Effect Of COVID-19 on Children's Lung Function: A Prospective Longitudinal Study.
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Akyan Soydaş Şule Selin, Ocak Ece, Gençoğlu Murat Yasin, Uytun Salih, Özkan Tabakçı Satı, Eryılmaz Polat Sanem, Tuğcu Gökçen Dilşa, Girit Saniye, Ayhan Yetkin, Besli Gülser Esen, Demir Sevliya Öcal, Çakır Erkan, Yazan Hakan, Türel Özden, Bursal Duramaz Burcu, Çokuğraş Haluk, Ayzıt Kılınç Ayşe, Kılıç Başkan Azer, Önal Pınar, Pekcan Sevgi, Ünal Gökçen, İmran Yılmaz Aslı, Akcan Özge Metin, Kartal Öztürk Gökçen, Beken Burçin, Karadağ Bülent, Eralp Ela Ertem, Gökdemir Yasemin, Hızal Mina, Vezir Emine, Aslan Ayşe Tana, Şişmanlar Eyüboğlu Tuğba, Tapısız Anıl, Demirdağ Tuğba Bedir, Öktem Sedat, Atağ Emine, Ünal Füsun, Kaşıkçı Merve, Cinel Güzin
Аннотация
MATERIAL AND METHODS: This prospective, longitudinal, multicenter study involved 270 patients with confirmed SARS-CoV-2 infection. Patients underwent pulmonary function tests (PFTs) (spirometry, diffusion capacity of the lung for carbon monoxide (DLCO), and plethysmography) at the 3rd and 6th months of follow-up. Clinical characteristics, radiological, and laboratory findings during AIP were analyzed to establish the relationship with PFT parameters on long-term follow-up.
RESULTS: The mean age was 12.97 ± 3.43 years (6-18 years), and 141(52.2%) were girls. Most patients had mild disease, while 193 patients were classified as having pneumonia. Overall mean PFT parameters were normal at the 3rd and 6th months, and FEV1%, FVC%, and DLCOadj% showed statistically significant longitudinal changes. Abnormal DLCOadj was observed in patients with COVID-19 pneumonia at the 6th month when compared with the non-pneumonia group (p = 0.046). At the 3rd month follow-up, comorbidities were independently associated with abnormal FEV1 (OR 6.30, 95% CI 2.61-15.17, p < 0.001) and abnormal FVC (OR 3.47, 95% CI 1.72-7.00, p < 0.001). Respiratory system related abnormal physical examination findings were also independently associated with abnormal FEV1 (OR 3.04, 95% CI 1.13-8.21, p = 0.028). Dyspnea showed a borderline association with abnormal FVC (OR 2.11, 95% CI 0.98-4.54, p = 0.057). Pathologic chest radiography, interlobular septal thickening on thorax CT, ground-glass opacity, fever, dyspnea, and respiratory system related abnormal physical examination findings during the AIP were associated with abnormal PFT parameters during follow-up. Disease severity scores did not differ significantly between children with normal and abnormal.
CONCLUSIONS: Most children had preserved mean pulmonary function during follow-up after SARS-CoV-2 infection. However, children with COVID-19 pneumonia, comorbidities, and respiratory system related abnormal physical examination findings during the AIP may be at increased risk for persistent functional abnormalities. Follow-up assessment in higher-risk children should include spirometry, and DLCO measurement should be considered when feasible.