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Impulse oscillometry assessment of respiratory function in pediatric patients with a history of COVID-19
Adnan Mercan1, Simge Atar Beşe1, Zeynep Güleç Köksal1
1Division of Pediatric Immunology and Allergy, Department of Pediatrics, Aydın Adnan Menderes University Faculty of Medicine, Aydın, Türkiye.
Insights
Children recovering from COVID-19 may experience prolonged respiratory issues, including elevated airway resistance. This study found increased total and peripheral airway resistance in children 3-6 months post-infection compared to healthy controls.
Area of Science:
- Pediatric pulmonology
- Infectious diseases
- Respiratory medicine
Background:
- Coronavirus disease 2019 (COVID-19) can lead to persistent respiratory symptoms in children, affecting up to one-third of pediatric cases for over 3 months.
- Understanding the long-term respiratory impact of COVID-19 in children is crucial for effective management and recovery strategies.
Purpose of the Study:
- To evaluate the respiratory functions of children aged 3-15 years, 3-6 months after recovering from COVID-19.
- To compare the respiratory function parameters of recovered pediatric COVID-19 patients with those of healthy children using impulse oscillometry (IOS).
Main Methods:
- A prospective cross-sectional study involving 63 children (3-15 years) who recovered from COVID-19 and 57 healthy controls matched for age and sex.
- Respiratory function was assessed using impulse oscillometry (IOS), measuring parameters like airway resistance (zR5, zR20, R5-20) and reactance (zX5, zX20, reactance area [AX], resonant frequency [Fres]).
Main Results:
- Children who recovered from COVID-19 showed significantly higher total and peripheral airway resistance (zR5, R5-20) compared to healthy controls.
- Reactance parameters (zX5, zX20) were significantly lower in the COVID-19 patient group, indicating altered respiratory mechanics.
- No significant differences were observed in central airway resistance (zR20), reactance area (AX), or resonant frequency (Fres) between the groups.
Conclusions:
- Children who have recovered from COVID-19 may exhibit persistent abnormalities in airway resistance up to 3-6 months post-infection.
- These findings highlight the potential for long-term respiratory sequelae in pediatric COVID-19 survivors, necessitating continued monitoring and research.
Objective:
While coronavirus disease 2019 (COVID-19) is generally considered to exhibit a less severe clinical course in children than in adults, studies have demonstrated that respiratory symptoms can endure for more than 3 months following infection in at least one-third of pediatric cases. The present study evaluates the respiratory functions of children aged 3-15 years within 3-6 months of their recovery from COVID-19 using impulse oscillometry (IOS) and compares them with the values of healthy children.
Methods:
Included in this prospective cross-sectional study were 63 patients (patient group) aged 3-15 years who contracted COVID-19 between December 2021 and May 2022, as well as 57 healthy children as a control group, matched for age and sex. The demographic, clinical, and laboratory data of the patients were recorded, and respiratory function was assessed based on airway resistance (zR5, zR20, R5-20) and reactance (zX5, zX20, reactance area [AX], resonant frequency [Fres]) using an IOS device.
Results:
There were no significant differences in the age, weight, height, and body weight z score values of the two groups (p > .05). While the zR5 and R5-20 levels of the patient group were higher (p = .008 and p < .001, respectively) than those of the controls, the zR20, AX, and Fres values did not differ significantly between the groups (p > .05). The parameters indicating the reactance, including zX5 and zX20, were significantly lower in the patient group than in the control group (p = .028 and p < .001, respectively).
Conclusion:
Total and peripheral airway resistances were found to be elevated in children who had recovered from COVID-19 in the preceding 3-6 months.
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