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Evaluation of long-term pulmonary functions after COVID-19 infection in children: a longitudinal observational cohort
Muhammet F Korkmaz1, Gülsüm E Şenkan1, Şefika Elmas Bozdemir2
1Department of Pediatrics, University of Health Sciences, Bursa Faculty of Medicine, City Training and Research Hospital, Bursa, Turkey.
Insights
Long-term follow-up of children after coronavirus disease 2019 (COVID-19) showed no significant pulmonary function differences between moderate and severe cases. Pulmonary function tests (PFTs) revealed similar outcomes approximately 15 months post-infection.
Area of Science:
- Pediatric pulmonology
- Infectious diseases
- Respiratory medicine
Background:
- Assessing long-term pulmonary function changes in children after COVID-19 hospitalization.
- Investigating potential differences based on disease severity (moderate vs. severe).
Purpose of the Study:
- To evaluate pulmonary function outcomes in pediatric COVID-19 survivors.
- To compare long-term lung function between moderate and severe COVID-19 cases in children.
Main Methods:
- Prospective longitudinal observational cohort study of 34 pediatric patients (7-18 years).
- Pulmonary function tests (PFTs) using spirometry performed approximately 15 months post-infection.
- Comparison of PFT results between moderate (n=25) and severe (n=9) COVID-19 groups.
Main Results:
- No significant demographic, clinical, or outcome differences between severity groups during hospitalization.
- Overall, 24% of children had abnormal PFTs (7% obstructive, 3% restrictive).
- No statistically significant differences in pulmonary function between moderate and severe COVID-19 groups at long-term follow-up (p=0.105).
Conclusions:
- Pediatric COVID-19 survivors, regardless of initial severity, demonstrate similar long-term pulmonary function.
- Observed PFT abnormalities (obstructive/restrictive patterns) did not significantly differ between moderate and severe cases.
- Persistent respiratory symptoms did not correlate with PFT differences in this cohort.
Introduction:
We aimed to present the changes that may occur in pulmonary functions in children who experienced more severe coronavirus disease 2019 (COVID-19) during long-term follow-up.
Methodology:
A prospective longitudinal observational cohort study was conducted with 34 pediatric patients (7-18 years) who were hospitalized with COVID-19 infection (moderate n = 25, severe n = 9), and followed up at our Pediatric Infection Outpatient Clinic for approximately two years. Pulmonary function tests (PFTs) were performed using spirometry.
Results:
Data from the hospitalization period revealed no significant differences between the severity groups in terms of demographic, clinical, laboratory, radiological, treatment, and outcome (p > 0.05). The median time interval between COVID-19 infection and PFTs was 15 months (range 11-29 months), and there was no significant difference between severity groups (p = 0.878). Eight patients (24%) had abnormal pulmonary functions; among them, seven had an obstructive pattern (21%) and one had a restrictive pattern (3%). The severity groups had no statistical difference in pulmonary functions (p = 0.105). While forced expiratory volume in 1 second (FEV1) %, FEV1/forced vital capacity (FVC)%, and forced expiratory flow during the middle half of FVC (FEF25-75%) ratios were lower in the severe patient group, Z-scores were similar. Among the patients continuing polyclinic follow-up, 41% had persistent respiratory symptoms before PFTs. No differences were observed in PFTs when compared based on the presence of symptoms (p > 0.05).
Conclusions:
We observed no significant long-term differences in pulmonary function between moderate and severe COVID-19 cases in children.
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