Functional respiratory complaints among COVID-19 survivors: a prospective cohort study.

Autor:	Beurnier A; Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.; INSERM UMR_S 999, Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, Le Plessis Robinson, France.; AP-HP, Department of Physiology - Pulmonary Function Testing, DMU 5 Thorinno, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.; These authors contributed equally., Savale L; Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.; INSERM UMR_S 999, Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, Le Plessis Robinson, France.; AP-HP, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, DMU 5 Thorinno, Le Kremlin-Bicêtre, France.; These authors contributed equally., Jaïs X; Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.; INSERM UMR_S 999, Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, Le Plessis Robinson, France.; AP-HP, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, DMU 5 Thorinno, Le Kremlin-Bicêtre, France., Colle R; Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.; AP-HP, Service de psychiatrie, Hôpital de Bicêtre, DMU 11, Equipe MOODS, INSERM U1018, CESP (Centre de Recherche en Epidémiologie et Santé des Populations), Le Kremlin-Bicêtre, France., Pham T; Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.; AP-HP, Service de Médecine Intensive-Réanimation, Hôpital de Bicêtre, DMU 4 CORREVE Maladies du Cœur et des Vaisseaux, FHU Sepsis, Le Kremlin-Bicêtre, France.; INSERM UMR_S1018, Equipe d'Epidémiologie Respiratoire Intégrative, CESP, Villejuif, France., Morin L; Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.; AP-HP, Service de Réanimation Pédiatrique et Médecine Néonatale, Hôpital de Bicêtre, Santé de l'Enfant et de l'Adolescent, Le Kremlin-Bicêtre, France., Bulifon S; Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.; INSERM UMR_S 999, Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, Le Plessis Robinson, France.; AP-HP, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, DMU 5 Thorinno, Le Kremlin-Bicêtre, France., Noël N; Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.; AP-HP, Service de Médecine Interne et Immunologie Clinique, Hôpital de Bicêtre, DMU 7 Endocrinologie-Immunités-Inflammations-Cancer-Urgences, Le Kremlin-Bicêtre, France AP., Boucly A; Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.; INSERM UMR_S 999, Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, Le Plessis Robinson, France.; AP-HP, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, DMU 5 Thorinno, Le Kremlin-Bicêtre, France., Delbarre B; AP-HP, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, DMU 5 Thorinno, Le Kremlin-Bicêtre, France., Ebstein N; Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.; INSERM UMR_S 999, Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, Le Plessis Robinson, France.; AP-HP, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, DMU 5 Thorinno, Le Kremlin-Bicêtre, France., Figueiredo S; Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.; HP, Service de Réanimation Chirurgicale, Hôpital de Bicêtre, DMU 12 Anesthésie, Réanimation, Douleur, Le Kremlin-Bicêtre, France., Gasnier M; Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.; AP-HP, Service de psychiatrie, Hôpital de Bicêtre, DMU 11, Equipe MOODS, INSERM U1018, CESP (Centre de Recherche en Epidémiologie et Santé des Populations), Le Kremlin-Bicêtre, France., Harrois A; Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.; HP, Service de Réanimation Chirurgicale, Hôpital de Bicêtre, DMU 12 Anesthésie, Réanimation, Douleur, Le Kremlin-Bicêtre, France., Jutant EM; Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.; INSERM UMR_S 999, Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, Le Plessis Robinson, France.; AP-HP, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, DMU 5 Thorinno, Le Kremlin-Bicêtre, France., Jevnikar M; Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.; INSERM UMR_S 999, Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, Le Plessis Robinson, France.; AP-HP, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, DMU 5 Thorinno, Le Kremlin-Bicêtre, France., Keddache S; Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.; INSERM UMR_S 999, Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, Le Plessis Robinson, France.; AP-HP, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, DMU 5 Thorinno, Le Kremlin-Bicêtre, France., Lecoq AL; Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.; AP-HP, Centre de Recherche Clinique Paris-Saclay, DMU 13 Santé Publique, Information Médicale, Appui à la Recherche Clinique, INSERM U1018, CESP, Le Kremlin-Bicêtre, France., Meyrignac O; Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.; AP-HP, Service de Radiologie Diagnostique et Interventionnelle, Hôpital de Bicêtre, DMU 14 Smart Imaging, BioMaps, Le Kremlin-Bicêtre, France., Parent F; Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.; INSERM UMR_S 999, Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, Le Plessis Robinson, France.; AP-HP, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, DMU 5 Thorinno, Le Kremlin-Bicêtre, France., Pichon J; Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.; INSERM UMR_S 999, Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, Le Plessis Robinson, France.; AP-HP, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, DMU 5 Thorinno, Le Kremlin-Bicêtre, France., Preda M; Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.; INSERM UMR_S 999, Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, Le Plessis Robinson, France.; AP-HP, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, DMU 5 Thorinno, Le Kremlin-Bicêtre, France., Roche A; Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.; INSERM UMR_S 999, Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, Le Plessis Robinson, France.; AP-HP, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, DMU 5 Thorinno, Le Kremlin-Bicêtre, France., Seferian A; Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.; INSERM UMR_S 999, Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, Le Plessis Robinson, France.; AP-HP, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, DMU 5 Thorinno, Le Kremlin-Bicêtre, France., Bellin MF; Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.; AP-HP, Service de Radiologie Diagnostique et Interventionnelle, Hôpital de Bicêtre, DMU 14 Smart Imaging, BioMaps, Le Kremlin-Bicêtre, France., Gille T; INSERM U1272, Hypoxia and the Lung, UFR SMBH Léonard de Vinci, Université Sorbonne Paris Nord, Bobigny, France.; AP-HP, Department of Physiology and Functional Explorations, DMU NARVAL, Hôpitaux Universitaires de Paris Seine-Saint-Denis, Sites Avicenne (Bobigny) et Jean Verdier (Bondy), France., Corruble E; Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.; AP-HP, Service de psychiatrie, Hôpital de Bicêtre, DMU 11, Equipe MOODS, INSERM U1018, CESP (Centre de Recherche en Epidémiologie et Santé des Populations), Le Kremlin-Bicêtre, France., Sitbon O; Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.; INSERM UMR_S 999, Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, Le Plessis Robinson, France.; AP-HP, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, DMU 5 Thorinno, Le Kremlin-Bicêtre, France., Becquemont L; Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.; AP-HP, Centre de Recherche Clinique Paris-Saclay, DMU 13 Santé Publique, Information Médicale, Appui à la Recherche Clinique, INSERM U1018, CESP, Le Kremlin-Bicêtre, France., Monnet X; Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.; INSERM UMR_S 999, Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, Le Plessis Robinson, France.; AP-HP, Service de Médecine Intensive-Réanimation, Hôpital de Bicêtre, DMU 4 CORREVE Maladies du Cœur et des Vaisseaux, FHU Sepsis, Le Kremlin-Bicêtre, France., Humbert M; Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.; INSERM UMR_S 999, Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, Le Plessis Robinson, France.; AP-HP, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, DMU 5 Thorinno, Le Kremlin-Bicêtre, France., Montani D; Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.; INSERM UMR_S 999, Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, Le Plessis Robinson, France.; AP-HP, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, DMU 5 Thorinno, Le Kremlin-Bicêtre, France.
Jazyk:	angličtina
Zdroj:	ERJ open research [ERJ Open Res] 2023 May 02; Vol. 9 (3). Date of Electronic Publication: 2023 May 02 (Print Publication: 2023).
DOI:	10.1183/23120541.00063-2023
Abstrakt:	Background: Dyspnoea is a common persistent symptom after COVID-19. Whether it is associated with functional respiratory disorders remains unclear. Methods: We assessed the proportion and characteristics of patients with "functional respiratory complaints" (FRCs) (as defined by Nijmegen Questionnaire >22) among 177 post-COVID-19 individuals who benefited from outclinic evaluation in the COMEBAC study ( i.e. , symptomatic and/or intensive care unit (ICU) survivors at 4 months). In a distinct explanatory cohort of 21 consecutive individuals with unexplained post-COVID-19 dyspnoea after routine tests, we also analysed the physiological responses to incremental cardiopulmonary exercise testing (CPET). Findings: In the COMEBAC cohort, 37 patients had significant FRCs (20.9%, IC95: 14.9-26.9). The prevalence of FRCs ranged from 7.2% (ICU patients) to 37.5% (non-ICU patients). The presence of FRCs was significantly associated with more severe dyspnoea, lower 6-min walk distance, more frequent psychological and neurological symptoms (cognitive complaint, anxiety, depression, insomnia and post-traumatic stress disorders) and poorer quality of life (all p<0.01). In the explanatory cohort, seven out of 21 patients had significant FRCs. Based on CPET, dysfunctional breathing was identified in 12 out of 21 patients, five out of 21 had normal CPET, three out of 21 had deconditioning and one out of 21 had evidence of uncontrolled cardiovascular disease. Interpretation: FRCs are common during post-COVID-19 follow-up, especially among patients with unexplained dyspnoea. Diagnosis of dysfunctional breathing should be considered in those cases. Competing Interests: Conflict of interest: A. Beurnier reports personal fees from Sanofi and AstraZeneca, outside the submitted work. Conflict of interest: L. Savale reports personal fees and nonfinancial support from Janssen and MSD, and grants, personal fees and nonfinancial support from GSK, outside the submitted work. Conflict of interest: X. Jaïs reports grants and personal fees from Janssen, grants and personal fees from MSD, and grants from Bayer and GSK, outside the submitted work. Conflict of interest: T. Gille reports personal fees from Roche SAS, and other support from Oxyvie (oxygen provider), Vivisol France (oxygen provider) and Menarini France, outside the submitted work. Conflict of interest: O. Sitbon reports grants from Acceleron, AOP Orphan, Janssen, GSK and MSD; consulting fees from Altavant, Gossamer Bio, Janssen and MSD; lecture honoraria from AOP Orphan, Janssen, Ferrer and MSD; and participation on advisory boards for Acceleron, Altavant, Gossamer Bio, Janssen, MSD and Ferrer, all outside the submitted work. Conflict of interest: Marc Humbert reports grants from Acceleron, AOP Orphan, Janssen, Merck and Shou Ti; consulting fees from Acceleron, Aerovate, Altavant, AOP Orphan, Bayer, Chiesi, Ferrer, Janssen, Merck, MorphogenIX, Shou Ti and United Therapeutics; lecture honoraria from Janssen and Merck; and advisory board participation for Acceleron, Altavant, Janssen, Merck and United Therapeutics, all outside the submitted work. Conflict of interest: D. Montani reports grants from Acceleron, Janssen and Merck; consulting fees from Acceleron; and lecture honoraria from Bayer, Janssen and Merck, all outside the submitted work. Conflict of interest: All other authors have nothing to disclose. (Copyright ©The authors 2023.)
Databáze:	MEDLINE
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