Functional respiratory complaints among COVID-19 survivors: a prospective cohort study.
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Beurnier Antoine, Savale Laurent, Jaïs Xavier, Colle Romain, Pham Tai, Morin Luc, Bulifon Sophie, Noël Nicolas, Boucly Athénaïs, Delbarre Benoit, Ebstein Nathan, Figueiredo Samy, Gasnier Matthieu, Harrois Anatole, Jutant Etienne-Marie, Jevnikar Mitja, Keddache Sophia, Lecoq Anne-Lise, Meyrignac Olivier, Parent Florence, Pichon Jérémie, Preda Mariana, Roche Anne, Seferian Andrei, Bellin Marie-France, Gille Thomas, Corruble Emmanuelle, Sitbon Olivier, Becquemont Laurent, Monnet Xavier, Humbert Marc, Montani David, and the Comebac Investigators, Comebac Investigators
Аннотация
METHODS: We assessed the proportion and characteristics of patients with "functional respiratory complaints" (FRCs) (as defined by Nijmegen Questionnaire >22) among 177 post-COVID-19 individuals who benefited from outclinic evaluation in the COMEBAC study (i.e., symptomatic and/or intensive care unit (ICU) survivors at 4 months). In a distinct explanatory cohort of 21 consecutive individuals with unexplained post-COVID-19 dyspnoea after routine tests, we also analysed the physiological responses to incremental cardiopulmonary exercise testing (CPET).
FINDINGS: In the COMEBAC cohort, 37 patients had significant FRCs (20.9%, IC95: 14.9-26.9). The prevalence of FRCs ranged from 7.2% (ICU patients) to 37.5% (non-ICU patients). The presence of FRCs was significantly associated with more severe dyspnoea, lower 6-min walk distance, more frequent psychological and neurological symptoms (cognitive complaint, anxiety, depression, insomnia and post-traumatic stress disorders) and poorer quality of life (all p<0.01). In the explanatory cohort, seven out of 21 patients had significant FRCs. Based on CPET, dysfunctional breathing was identified in 12 out of 21 patients, five out of 21 had normal CPET, three out of 21 had deconditioning and one out of 21 had evidence of uncontrolled cardiovascular disease.
INTERPRETATION: FRCs are common during post-COVID-19 follow-up, especially among patients with unexplained dyspnoea. Diagnosis of dysfunctional breathing should be considered in those cases.