Chronic obstructive pulmonary disease, asthma, and mechanical ventilation are risk factors for dyspnea in patients with long COVID: A Japanese nationwide cohort study

IF 2.4 Q2 RESPIRATORY SYSTEM

Respiratory investigation Pub Date : 2024-09-28 DOI:10.1016/j.resinv.2024.09.009

Emiko Matsuyama , Jun Miyata , Hideki Terai , Naoki Miyazaki , Toshiki Iwasaki , Kengo Nagashima , Mayuko Watase , Keeya Sunata , Ho Namkoong , Takanori Asakura , Katsunori Masaki , Shotaro Chubachi , Keiko Ohgino , Ichiro Kawada , Kazuhiro Minami , Rie Hagiwara , Soichiro Ueda , Takashi Yoshiyama , Hiroyuki Kokuto , Tatsuya Kusumoto , Koichi Fukunaga

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引用次数: 0

Abstract

Background

Patients often experience multiple prolonged symptoms following acute coronavirus disease 2019 (COVID-19) recovery, defined as long coronavirus disease (COVID). Patients with long COVID may experience dyspnea during acute and post-acute phases. Therefore, this study aimed to identify specific risk factors for dyspnea in patients with long COVID.

Methods

Hospitalized patients with COVID-19, aged ≥18 years, were enrolled in this multicenter cohort study conducted at 26 medical institutions across Japan. Clinical data during hospitalization and patient-reported outcomes after discharge at the 3, 6, and 12-month follow-ups were retrieved from medical records and paper-based or smartphone application-based questionnaires, respectively.

Results

Generalized linear mixed model (GLMM) analysis of prolonged dyspnea at each time point during follow-up showed that this symptom was associated with chronic obstructive pulmonary disease (COPD) (odds ratio [OR], 2.74; 95% confidence interval [CI], 1.31–5.74), asthma (OR, 2.21; 95%CI, 1.17–4.16), and ventilator management (OR, 3.10; 95%CI, 1.65–5.83). In addition, patients with COPD (44.4%) and ventilator management (25.0%) were more frequently associated with delayed dyspnea onset. The generalized estimating equations analysis results with multiple imputed datasets, conducted as a sensitivity analysis, confirmed the adjusted GLMM analysis results.

Conclusions

Prolonged dyspnea was associated with COPD, asthma, and severe infection that required mechanical ventilation in the Japanese population with long COVID. Further investigation is needed to clarify its mechanism and develop prophylactic and therapeutic strategies for dyspnea in patients with long COVID.

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慢性阻塞性肺病、哮喘和机械通气是导致长 COVID 患者呼吸困难的危险因素：一项日本全国性队列研究

背景患者在急性冠状病毒病 2019（COVID-19）康复后往往会出现多种长期症状，这被定义为长冠状病毒病（COVID）。长程冠状病毒病患者在急性期和急性期后可能会出现呼吸困难。因此，本研究旨在确定长程冠状病毒病患者出现呼吸困难的特定风险因素。方法在日本全国 26 家医疗机构开展的这项多中心队列研究纳入了年龄≥18 岁的 COVID-19 住院患者。住院期间的临床数据和出院后 3 个月、6 个月和 12 个月随访时的患者报告结果分别来自病历和纸质或智能手机应用问卷。结果对随访期间每个时间点的长时间呼吸困难进行广义线性混合模型（GLMM）分析后发现，该症状与慢性阻塞性肺病（COPD）（几率比[OR]，2.74；95%置信区间[CI]，1.31-5.74）、哮喘（OR，2.21；95%CI，1.17-4.16）和呼吸机管理（OR，3.10；95%CI，1.65-5.83）有关。此外，慢性阻塞性肺病患者（44.4%）和呼吸机管理患者（25.0%）更经常与呼吸困难延迟发生有关。作为一项敏感性分析，使用多个估算数据集进行的广义估计方程分析结果证实了调整后的 GLMM 分析结果。需要进一步研究以明确其机制，并制定针对长 COVID 患者呼吸困难的预防和治疗策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Respiratory investigation RESPIRATORY SYSTEM-

CiteScore

4.90

自引率

6.50%

发文量

114

审稿时长

64 days