Peculiarities of the clinical course and risk factors of long-lasting post-COVID syndrome in patients with shortness of breath

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Аннотация

Post-COVID syndrome (PCS) has a high prevalence rate (from 4 to 80%) and is represented by more than 200 symptoms, including shortness of breath. At the same time, the structure of risk factors, pathogenetic mechanisms of prolonged PCS have not been sufficiently studied. Study of these issues is a promising direction in therapy, which can help in preventing the occurrence of PCS and ensuring its effective treatment.

The aim: to determine the prevalence, peculiarities of clinical course and risk factors for long-lasting PCS development in patients with dyspnea.

Material and methods. A screening cross-sectional clinical study was performed. 887 patients applied to outpatient clinic due to shortness of breath after a new coronavirus infection (NCVI) from March 2020 to August 2023. The study included 205 individuals, who were divided into 3 groups: 1st – 62 patients with PCS > 3 months; 2nd – 52 patients with PCS < 3 months; 3rd – 91 patients without PCS.

Results. The average duration of the period after a new coronavirus infection in studied patients was 7.3 [3.2; 12.8] months. Patients in the group with PCS ≥ 3 months had statistically significantly higher mean values for NCVI with hospitalization, NCVI with pneumonia, NCVI accompanied by weakness, NCVI with general feeling of being unwell, NCVI with cognitive impairment, NCVI with dyspnea, NCVI with significant lung damage. An increase of D-dimer level increased the odds ratio (OR) of developing PCS lasting > 3 months by 4 times, and an increase of N-terminal fragment of the B-type brain natriuretic peptide (NT-proBNP) – by 9.4 times comparatively to the group of patients without PCS. An increase in the concentration of tumor necrosis factor-alpha increased the OR of developing PCS lasting < 3 months by 8 times comparatively to the group of patients without PCS.

Conclusion. The severity of NCVI clinical course with hospitalization, pneumonia, appearance of pulmonary fibrosis affects the formation of long-lasting PCS. Risk factors for the development of long-lasting PCS include increased levels of D-dimer, NT-proBNP, increased body mass index, left ventricular myocardial hypertrophy.

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Авторлар туралы

Olga Masalkina

Academician E.A. Wagner Perm State Medical University of the Ministry of Healthcare of Russia

Хат алмасуға жауапты Автор.
Email: omasalkina@mail.ru
ORCID iD: 0009-0006-3364-0591
SPIN-код: 4394-5330

MD, PhD (Medicine), associate professor of the Department of internal medicine propaedeutics No. 2

Ресей, Perm

Elena Polyanskaya

Academician E.A. Wagner Perm State Medical University of the Ministry of Healthcare of Russia

Email: eapolyanskaya@gmail.com
ORCID iD: 0000-0002-3694-3647
SPIN-код: 6413-8930

MD, Dr. Sci. (Medicine), associate professor of the Department of internal medicine propaedeutics No. 2

Ресей, Perm

Natalya Koziolova

Academician E.A. Wagner Perm State Medical University of the Ministry of Healthcare of Russia

Email: nakoziolova@mail.ru
ORCID iD: 0000-0001-7003-5186
SPIN-код: 1044-0503

MD, Dr. Sci. (Medicine), professor, head of the Department of internal medicine propaedeutics No. 2

Ресей, Perm

Anna Chernyavina

Academician E.A. Wagner Perm State Medical University of the Ministry of Healthcare of Russia

Email: anna_chernyavina@list.ru
ORCID iD: 0000-0002-0051-6694
SPIN-код: 2387-6781

MD, Dr. Sci. (Medicine), associate professor of the Department of internal medicine propaedeutics No. 2

Ресей, Perm

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