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Published on: August 7, 2017
Long-Term Effect Of COVID-19 on Children's Lung Function: A Prospective Longitudinal Study
Şule Selin Akyan Soydaş1, Ece Ocak1, Murat Yasin Gençoğlu1
1Department of Pediatric Pulmonology, Ministry of Health Ankara Bilkent City Hospital, Ankara, Turkey.
Insights
Most children recover lung function after COVID-19, but those with pneumonia or comorbidities may face lasting issues. Pulmonary function tests (PFTs) are recommended for high-risk children, including diffusion capacity of the lung for carbon monoxide (DLCO) measurement.
Area of Science:
- Pediatric Pulmonology
- Infectious Diseases
- Respiratory Medicine
Background:
- The long-term effects of SARS-CoV-2 infection on pediatric lung function remain an area of active investigation.
- Understanding post-COVID-19 respiratory sequelae in children is crucial for guiding clinical management and follow-up strategies.
Purpose of the Study:
- To evaluate the long-term impact of COVID-19 on pulmonary function in children.
- To identify clinical, radiological, and laboratory predictors of persistent lung function abnormalities after SARS-CoV-2 infection.
Main Methods:
- A prospective, longitudinal, multicenter study involving 270 children with confirmed SARS-CoV-2 infection.
- Pulmonary function tests (PFTs), including spirometry and DLCO, were performed at 3 and 6 months post-infection.
- Analysis correlated acute infection period (AIP) findings with long-term PFT parameters.
Main Results:
- Overall mean PFT parameters were normal at 3 and 6 months, but significant longitudinal changes were observed in FEV1%, FVC%, and DLCOadj%.
- Children with COVID-19 pneumonia showed abnormal DLCOadj at 6 months compared to those without pneumonia (p=0.046).
- Comorbidities and abnormal respiratory physical examination findings during AIP were independently associated with abnormal FEV1 and FVC at 3 months.
Conclusions:
- Most children exhibit preserved lung function after SARS-CoV-2 infection.
- Children with COVID-19 pneumonia, comorbidities, or specific AIP findings are at higher risk for persistent functional abnormalities.
- Follow-up PFTs, including spirometry and potentially DLCO, are recommended for higher-risk pediatric patients.
Introduction-Aim:
The study evaluates the long-term effect of COVID-19 on lung function in children, considering symptoms, physical examination findings, radiologic and laboratory evaluations during the acute infection period (AIP).
Material And Methods:
This prospective, longitudinal, multicenter study involved 270 patients with confirmed SARS-CoV-2 infection. Patients underwent pulmonary function tests (PFTs) (spirometry, diffusion capacity of the lung for carbon monoxide (DLCO), and plethysmography) at the 3rd and 6th months of follow-up. Clinical characteristics, radiological, and laboratory findings during AIP were analyzed to establish the relationship with PFT parameters on long-term follow-up.
Results:
The mean age was 12.97 ± 3.43 years (6-18 years), and 141(52.2%) were girls. Most patients had mild disease, while 193 patients were classified as having pneumonia. Overall mean PFT parameters were normal at the 3rd and 6th months, and FEV1%, FVC%, and DLCOadj% showed statistically significant longitudinal changes. Abnormal DLCOadj was observed in patients with COVID-19 pneumonia at the 6th month when compared with the non-pneumonia group (p = 0.046). At the 3rd month follow-up, comorbidities were independently associated with abnormal FEV1 (OR 6.30, 95% CI 2.61-15.17, p < 0.001) and abnormal FVC (OR 3.47, 95% CI 1.72-7.00, p < 0.001). Respiratory system related abnormal physical examination findings were also independently associated with abnormal FEV1 (OR 3.04, 95% CI 1.13-8.21, p = 0.028). Dyspnea showed a borderline association with abnormal FVC (OR 2.11, 95% CI 0.98-4.54, p = 0.057). Pathologic chest radiography, interlobular septal thickening on thorax CT, ground-glass opacity, fever, dyspnea, and respiratory system related abnormal physical examination findings during the AIP were associated with abnormal PFT parameters during follow-up. Disease severity scores did not differ significantly between children with normal and abnormal.
Conclusions:
Most children had preserved mean pulmonary function during follow-up after SARS-CoV-2 infection. However, children with COVID-19 pneumonia, comorbidities, and respiratory system related abnormal physical examination findings during the AIP may be at increased risk for persistent functional abnormalities. Follow-up assessment in higher-risk children should include spirometry, and DLCO measurement should be considered when feasible.
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