Intra-breath Oscillometry is Associated With Patient-reported Symptoms and 6-minute Walk Distance at 6 Months After Mild COVID-19 Infection
Notice bibliographique
Résumé
Abstract Background: The mechanisms responsible for the persistent respiratory symptoms with mild acute COVID-19, defined by management as outpatients, have not been fully characterized as most patients have normal spirometry. Oscillometry is a different pulmonary function test that measures respiratory impedance to superimposed small pressure signals during normal breathing. It is highly sensitive to changes in lung mechanics. The current standard oscillometry output provides measurement of the mean impedance of a tidal breath. Intra-breath oscillometry is a novel technique that tracks respiratory impedance during tidal breathing to provide more detailed information about changes in lung mechanics. No studies have assessed respiratory function after acute COVID-19 infection using intra-breath oscillometry. Methods: Mild acute COVID-19 patients were enrolled in the CANCOV study at the University Health Network, and evaluated with oscillometry, spirometry, patient-reported symptom checklist, 6-minute walk distance (6MWD) test and Borg dyspnea scale between August 2020 and March 2022. Date of infection was defined by symptom onset and/or positive rapid antigen test. The intra-breath oscillometry metrics of interest were resistance at end-expiration (ReE) and end-inspiration (ReI) and reactance at end-expiration (XeE) and end-inspiration (XeI). Regression analyses were used to identify association between intra-breath oscillometry, symptoms, 6MWD and Borg dyspnea score with adjustment for age, sex and height. Results: The cohort consisted of 177 outpatients with 57.3% females and median age of 45.2 years. Spirometry was normal at 6 months post-infection. Median (IQR) z-scores of forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1)/FVC were 0.09 (-0.57, 0.66) and -0.22 (-0.76, 0.14); the FEV1/FVC ratio was 0.80 (0.77, 0.84), respectively. Most patients (51.7%) reported persistent symptoms including chest heaviness/tightness/pain, shortness of breath, breathing harder/faster at rest, breathing faster than normal, and fatigue. Moreover, 21.1% had functional impairment as reflected by 6MWD < lower limit of normal. Logistic regression identified ReE, ReI, XeE and XeI to be highly associated with patient-reported symptoms (P < 0.05). Linear regression revealed these metrics to be significantly associated with 6MWD and Borg dyspnea scores (P < 0.05). In contrast, spirometry did not show significant associations with patient-reported symptoms, 6MWD or Borg dyspnea score. Conclusions: At 6-months after mild acute COVID-19 infection, intra-breath oscillometry identified abnormal lung mechanics that were indiscernible by standard oscillometry and spirometry. Furthermore, the intra-breath measures were significantly associated with subjective respiratory symptoms and objective metrics that include the Borg dyspnea score and functional outcome as captured by the 6MWD.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».