Small Airways Dysfunction and Lung Hyperinflation in Long COVID-19 Patients as Potential Mechanisms of Persistent Dyspnoea

Adv Respir Med. 2024 Aug 23;92(5):329-337. doi: 10.3390/arm92050031.

Abstract

Background: Reticulation, ground glass opacities and post-infection bronchiectasis are present three months following hospitalisation in patients recovering from SARS-CoV-2 infection and are associated with the severity of acute infection. However, scarce data exist on small airways impairment and lung hyperinflation in patients with long COVID-19.

Aim: To evaluate small airways function and lung hyperinflation in previously hospitalised patients with long COVID-19 and their association with post-COVID-19 breathlessness.

Methods: In total, 33 patients (mean ± SD, 53 ± 11 years) with long COVID-19 were recruited 149 ± 90 days following hospital discharge. Pulmonary function tests were performed and lung hyperinflation was defined as RV/TLC ≥ 40%. Small airways function was evaluated by measuring the closing volume (CV) and closing capacity (CC) using the single-breath nitrogen washout technique (SBN2W).

Results: CC was 115 ± 28% pred. and open capacity (OC) was 90 ± 19. CC was abnormal in 13 patients (39%), CV in 2 patients (6.1%) and OC in 9 patients (27%). Lung hyperinflation was present in 15 patients, whilst the mean mMRC score was 2.2 ± 1.0. Lung hyperinflation was associated with CC (r = 0.772, p = 0.001), OC (r = 0.895, p = 0.001) and mMRC (r = 0.444, p = 0.010).

Conclusions: Long COVID-19 patients present with small airways dysfunction and lung hyperinflation, which is associated with persistent dyspnoea, following hospitalisation.

Keywords: dyspnoea; long COVID-19; lung hyperinflation; small airways disease.

MeSH terms

  • Adult
  • Aged
  • COVID-19* / complications
  • COVID-19* / physiopathology
  • Dyspnea* / etiology
  • Dyspnea* / physiopathology
  • Female
  • Humans
  • Lung / diagnostic imaging
  • Lung / physiopathology
  • Male
  • Middle Aged
  • Post-Acute COVID-19 Syndrome
  • Respiratory Function Tests*
  • SARS-CoV-2

Grants and funding

This research received no external funding.