Altered lung physiology in two cohorts after COVID-19 infection as assessed by computed cardiopulmonography

<p>The longer-term effects of COVID-19 on lung physiology remain poorly understood. Here, a new technique, computed cardiopulmonography (CCP), was used to study two COVID-19 cohorts (MCOVID and C-MORE-LP) at both ∼6 and ∼12 mo after infection. CCP is comprised of two components. The first is c...

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Main Authors: Magor-Elliott, SRM, Alamoudi, A, Chamley, RR, Xu, H, Wellalagodage, T, McDonald, RP, O'Brien, D, Collins, J, Coombs, B, Winchester, J, Sellon, E, Xie, C, Sandhu, D, Fullerton, CJ, Couper, JH, Smith, NMJ, Richmond, G, Cassar, MP, Raman, B, Talbot, NP, Bennett, AN, Nicol, ED, Ritchie, GAD, Petousi, N, Holdsworth, DA, Robbins, PA
Format: Journal article
Language:English
Published: American Physiological Society 2022
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author Magor-Elliott, SRM
Alamoudi, A
Chamley, RR
Xu, H
Wellalagodage, T
McDonald, RP
O'Brien, D
Collins, J
Coombs, B
Winchester, J
Sellon, E
Xie, C
Sandhu, D
Fullerton, CJ
Couper, JH
Smith, NMJ
Richmond, G
Cassar, MP
Raman, B
Talbot, NP
Bennett, AN
Nicol, ED
Ritchie, GAD
Petousi, N
Holdsworth, DA
Robbins, PA
author_facet Magor-Elliott, SRM
Alamoudi, A
Chamley, RR
Xu, H
Wellalagodage, T
McDonald, RP
O'Brien, D
Collins, J
Coombs, B
Winchester, J
Sellon, E
Xie, C
Sandhu, D
Fullerton, CJ
Couper, JH
Smith, NMJ
Richmond, G
Cassar, MP
Raman, B
Talbot, NP
Bennett, AN
Nicol, ED
Ritchie, GAD
Petousi, N
Holdsworth, DA
Robbins, PA
author_sort Magor-Elliott, SRM
collection OXFORD
description <p>The longer-term effects of COVID-19 on lung physiology remain poorly understood. Here, a new technique, computed cardiopulmonography (CCP), was used to study two COVID-19 cohorts (MCOVID and C-MORE-LP) at both ∼6 and ∼12 mo after infection. CCP is comprised of two components. The first is collection of highly precise, highly time-resolved measurements of gas exchange with a purpose-built molecular flow sensor based around laser absorption spectroscopy. The second component is estimation of physiological parameters by fitting a cardiopulmonary model to the data set. The measurement protocol involved 7 min of breathing air followed by 5 min of breathing pure O2. One hundred seventy-eight participants were studied, with 97 returning for a repeat assessment. One hundred twenty-six arterial blood gas samples were drawn from MCOVID participants. For participants who had required intensive care and/or invasive mechanical ventilation, there was a significant increase in anatomical dead space of ∼30 mL and a significant increase in alveolar-to-arterial Po2 gradient of ∼0.9 kPa relative to control participants. Those who had been hospitalized had reductions in functional residual capacity of ∼15%. Irrespectively of COVID-19 severity, participants who had had COVID-19 demonstrated a modest increase in ventilation inhomogeneity, broadly equivalent to that associated with 15 yr of aging. This study illustrates the capability of CCP to study aspects of lung function not so easily addressed through standard clinical lung function tests. However, without measurements before infection, it is not possible to conclude whether the findings relate to the effects of COVID-19 or whether they constitute risk factors for more serious disease.</p> <p><strong>NEW & NOTEWORTHY </strong>This study used a novel technique, computed cardiopulmonography, to study the lungs of patients who have had COVID-19. Depending on severity of infection, there were increases in anatomical dead space, reductions in absolute lung volumes, and increases in ventilation inhomogeneity broadly equivalent to those associated with 15 yr of aging. However, without measurements taken before infection, it is unclear whether the changes result from COVID-19 infection or are risk factors for more severe disease.</p>
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spelling oxford-uuid:9cb61ef2-4029-415f-8114-4e86398655ff2022-12-09T12:07:31ZAltered lung physiology in two cohorts after COVID-19 infection as assessed by computed cardiopulmonographyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:9cb61ef2-4029-415f-8114-4e86398655ffEnglishSymplectic ElementsAmerican Physiological Society2022Magor-Elliott, SRMAlamoudi, AChamley, RRXu, HWellalagodage, TMcDonald, RPO'Brien, DCollins, JCoombs, BWinchester, JSellon, EXie, CSandhu, DFullerton, CJCouper, JHSmith, NMJRichmond, GCassar, MPRaman, BTalbot, NPBennett, ANNicol, EDRitchie, GADPetousi, NHoldsworth, DARobbins, PA<p>The longer-term effects of COVID-19 on lung physiology remain poorly understood. Here, a new technique, computed cardiopulmonography (CCP), was used to study two COVID-19 cohorts (MCOVID and C-MORE-LP) at both ∼6 and ∼12 mo after infection. CCP is comprised of two components. The first is collection of highly precise, highly time-resolved measurements of gas exchange with a purpose-built molecular flow sensor based around laser absorption spectroscopy. The second component is estimation of physiological parameters by fitting a cardiopulmonary model to the data set. The measurement protocol involved 7 min of breathing air followed by 5 min of breathing pure O2. One hundred seventy-eight participants were studied, with 97 returning for a repeat assessment. One hundred twenty-six arterial blood gas samples were drawn from MCOVID participants. For participants who had required intensive care and/or invasive mechanical ventilation, there was a significant increase in anatomical dead space of ∼30 mL and a significant increase in alveolar-to-arterial Po2 gradient of ∼0.9 kPa relative to control participants. Those who had been hospitalized had reductions in functional residual capacity of ∼15%. Irrespectively of COVID-19 severity, participants who had had COVID-19 demonstrated a modest increase in ventilation inhomogeneity, broadly equivalent to that associated with 15 yr of aging. This study illustrates the capability of CCP to study aspects of lung function not so easily addressed through standard clinical lung function tests. However, without measurements before infection, it is not possible to conclude whether the findings relate to the effects of COVID-19 or whether they constitute risk factors for more serious disease.</p> <p><strong>NEW & NOTEWORTHY </strong>This study used a novel technique, computed cardiopulmonography, to study the lungs of patients who have had COVID-19. Depending on severity of infection, there were increases in anatomical dead space, reductions in absolute lung volumes, and increases in ventilation inhomogeneity broadly equivalent to those associated with 15 yr of aging. However, without measurements taken before infection, it is unclear whether the changes result from COVID-19 infection or are risk factors for more severe disease.</p>
spellingShingle Magor-Elliott, SRM
Alamoudi, A
Chamley, RR
Xu, H
Wellalagodage, T
McDonald, RP
O'Brien, D
Collins, J
Coombs, B
Winchester, J
Sellon, E
Xie, C
Sandhu, D
Fullerton, CJ
Couper, JH
Smith, NMJ
Richmond, G
Cassar, MP
Raman, B
Talbot, NP
Bennett, AN
Nicol, ED
Ritchie, GAD
Petousi, N
Holdsworth, DA
Robbins, PA
Altered lung physiology in two cohorts after COVID-19 infection as assessed by computed cardiopulmonography
title Altered lung physiology in two cohorts after COVID-19 infection as assessed by computed cardiopulmonography
title_full Altered lung physiology in two cohorts after COVID-19 infection as assessed by computed cardiopulmonography
title_fullStr Altered lung physiology in two cohorts after COVID-19 infection as assessed by computed cardiopulmonography
title_full_unstemmed Altered lung physiology in two cohorts after COVID-19 infection as assessed by computed cardiopulmonography
title_short Altered lung physiology in two cohorts after COVID-19 infection as assessed by computed cardiopulmonography
title_sort altered lung physiology in two cohorts after covid 19 infection as assessed by computed cardiopulmonography
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