The influence of the criterion of abnormal DLco value on the prediction of impaired lung diffusion capacity after SARS-CoV-2 infection
https://doi.org/10.20538/1682-0363-2025-1-69-76
Abstract
Aim. To predict impaired lung diffusion capacity after SARS-CoV-2 infection depending on the criteria of pathological deviation of DLco value (carbon monoxide transfer factor).
Methods. The retrospective study included 341 patients (median age was 48 years, 76.8% of the participants were men) after SARS-CoV-2-associated lung injury. The median volume of lung injury during the acute phase of COVID-19 was 50%. All patients underwent a diffusion test. Descriptive statistics, logistic regression analysis were applied, taking into account the previously obtained model for prognosis of abnormal DLco (<80% of the predicted value (%pred.)) [11]. In the present study on the same sample of patients, the prognosis of abnormal DLco was studied depending on the criterion 1: DLco < 80%pred. or criterion 2: DLco < predicted – 1.645SD (SD — standard deviation. ROC analysis was used to assess the quality of the binary classifier models.
Results. The coefficients of the logistic regression equations were obtained on the training sample with regard to the chosen criterion of pathological deviation of DLco. The ROC analysis procedure showed that, when applying criterion 1, area under curve (AUC) was 0.776, p < 0.001 (0.707–0.824 95% confidence interval (CI)), sensitivity and specificity of the training model were 81% and 66%, respectively. When applying criterion 2, AUC was 0.759, p < 0.001 (0.701–0.817 95% CI), sensitivity and specificity of the training model were 83.4% and 59%, respectively.
Conclusions. The criterion for determining the lower limit of normal DLco (LLNDLco) does not significantly affect the quality of the model for impaired lung diffusion capacity prognosis after SARS-CoV-2-associated lung injury. It is advisable to give preference to a method that is easier to apply in practice.
About the Authors
O. I. Savushkina
Main Military Clinical Hospital named after academician N.N. Burdenko of the Russian Defense Ministry;
Pulmonology Scientific Research Institute under Federal Medical and Biological Agency of Russian Federation
Russian Federation
Competing Interests:
Russian Federation
3, Gospitalnaya Sq., Moscow, 105229;
28, Orekhovy Blvd., Moscow, 115682
Competing Interests:
The authors declare the absence of obvious or potential conflict of interest related to the publication of this article.
E. S. Muraveva
Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation
Russian Federation
Competing Interests:
Russian Federation
1, Ostrovityanova Str., Moscow, 117997
Competing Interests:
The authors declare the absence of obvious or potential conflict of interest related to the publication of this article.
D. V. Davydov
Main Military Clinical Hospital named after academician N.N. Burdenko of the Russian Defense Ministry
Russian Federation
Competing Interests:
Russian Federation
3, Gospitalnaya Sq., Moscow, 105229
Competing Interests:
The authors declare the absence of obvious or potential conflict of interest related to the publication of this article.
E. V. Kryukov
Military Medical Academy named after S. M. Kirov
Russian Federation
Competing Interests:
Russian Federation
6, Akademika Lebedeva Str., Saint Petersburg, 194044
Competing Interests:
The authors declare the absence of obvious or potential conflict of interest related to the publication of this article.
References
1. Канаев Н.Н., Шик Л.Л., Кузнецова В.К. Руководство по клинической физиологии дыхания; под ред. Л.Л. Шика, Н.Н. Канаева. Л.: Медицина, 1980:375.
2. American Thoracic Society. Evaluation of impairment/disability secondary to respiratory disorders. Am. Rev. Respir. Dis. 1986;133(6):1205–1209. DOI: 10.1164/arrd.1986.133.6.1205.
3. Stanojevic S., Kaminsky D.A., Miller M.R., Thompson B., Aliverti A., Barjaktarevic I. et al. ERS/ATS technical standard on interpretive strategies for routine lung function tests. Eur. Respir. J. 2022;60(1):2101499. DOI: 10.1183/13993003.01499-2021.
4. Скэнлон П.Д., Хайатт Р.Е. Интерпретация результатов легочных функциональных тестов; пер. с англ. под ред. О.И. Савушкиной, А.В. Черняка. М.: ГЭОТАР-Медиа, 2023:312. DOI: 10.33029/9704-7249-1-PFT- 2023-1-312.
5. Pellegrino R., Viegi G., Brusasco V., Crapo R.O., Burgos F., Casaburi R. et al. Interpretative strategies for lung function tests. Eur. Respir. J. 2005;26(5):948–968. DOI: 10.1183/09031936.05.00035205.
6. Навакатикян А.О. Некоторые пути повышения информативности функциональных исследований дыхания. Терапевтический архив. 1974;46(5):109–115.
7. Савушкина О.И., Муравьева Е.С., Авдеев С.Н., Кулагина И.Ц., Малашенко М.М., Зайцев А.А. Анализ функциональных показателей респираторной системы в разные сроки после перенесенной COVID-19. Туберкулез и болезни легких. 2023;101(6):42–49. DOI: 10.58838/2075-1230-2023-101-6-42-49.
8. Черняк А.В., Карчевская Н.А., Савушкина О.И., Мустафина М.Х., Синицын Е.А., Калманова Е.Н. и др. Функциональные изменения системы дыхания у пациентов, перенесших COVID-19-ассоциированное поражение легких. Пульмонология. 2022;32(4):558–567. DOI: 10.18093/0869-0189-2022-32-4-558-567.
9. Sanchez-Ramirez D.C., Normand K., Zhaoyun Y., Torres-Castro R. Long-Term Impact of COVID-19: A Systematic Review of the Literature and Meta-Analysis. Biomedicines. 2021;9(8):900. DOI: 10.3390/biomedicines9080900.
10. Савушкина О.И., Зайцев А.А., Черняк А.В., Малашенко М.М., Кулагина И.Ц., Крюков Е.В. Диффузионная способность лёгких при обследовании пациентов, перенесших COVID-19. Практическая пульмонология. 2020;(4):34–37.
11. Савушкина О.И., Муравьева Е.С., Житарева И.В., Давыдов Д.В., Крюков Е.В. Решающее правило для выявления пациентов с высоким риском нарушения диффузионной способности легких после перенесенного COVID-19. Бюллетень сибирской медицины. 2024;23(3):91–98. DOI: 10.20538/1682-0363-2024-3-91-98.
12. Graham B.L., Brusasco V., Burgos F., Cooper B.G., Jensen R., Kendrick A. et al. 2017 ERS/ATS Standards for single-breath carbon monoxide uptake in the lung. Eur. Respir. J. 2017;49(1):1600016. DOI: 10.1183/13993003.00016-2016.
13. Lai C.C., Hsu C.K., Yen M.Y., Lee P.I., Ko W.C., Hsueh P.R. Long COVID: An inevitable sequela of SARS-CoV-2 infection. J. Microbiol. Immunol. Infect. 2023;56(1):1–9. DOI: 10.1016/j.jmii.2022.10.003.
14. Bellan M., Soddu D., Balbo P.E., Baricich A., Zeppegno P., Avanzi G.C. et al. Respiratory and psychophysical sequelae among patients with COVID-19 four months after hospital discharge. JAMA Netw. Open. 2021;4(1):e2036142. DOI: 10.1001/jamanetworkopen.2020.36142.
15. Карчевская Н.А., Скоробогач И.М., Черняк А.В., Мигунова Е.В., Лещинская О.В., Калманова Е.Н. и др. Результаты отдаленного обследования пациентов после COVID-19. Терапевтический архив. 2022;94(3):378–388. DOI: 10.26442/00403660.2022.03.201399.
16. Wu X., Liu X., Zhou Y., Yu H., Li R., Zhan Q. et al. 3-month, 6-month, 9-month, and 12-month respiratory outcomes in patients following COVID-19-related hospitalisation: a prospective study. Lancet Respir. Med. 2021;9(7):747–754. DOI: 10.26442/00403660.2022.03.201399.
17. Kattainen S., Pitkänen H., Reijula J., Hästbacka J. Complete blood count, coagulation biomarkers, and lung function 6 months after critical COVID-19. Acta Anaesthesiol. Scand. 2024;68(7):940–948. DOI: 10.1111/aas.14437.
18. Chamley R.R., Holland J.L., Collins J., Pierce K., Watson W.D., Green P.G. et al. Exercise capacity following SARS-CoV-2 infection is related to changes in cardiovascular and lung function in military personnel. Int. J. Cardiol. 2024;395:131594. DOI: 10.1016/j.ijcard.2023.131594.
19. Han X., Chen L., Guo L., Wu L., Alwalid O., Liu J. et al. Long-term radiological and pulmonary function abnormalities at 3-year post COVID-19 hospitalization: a longitudinal cohort study. Eur. Respir. J. 2024;64(1):2301612. DOI: 10.1183/13993003.01612-2023.
20. Iversen K.K., Ronit A., Ahlström M.G., Nordestgaard B.G., Afzal S., Benfield T. Lung function trajectories in mild COVID-19 with two-year follow-up. J. Infect. Dis. 2024;229(6):1750–1758. DOI: 10.1093/infdis/jiae037.
21. Faverio P., Paciocco G., Tassistro E., Rebora P., Rossi E., Monzani A. et al. Two-year cardio-pulmonary follow-up after severe COVID-19: a prospective study. Intern. Emerg. Med. 2024;19(1):183–190. DOI: 10.1007/s11739-023-03400-x.
22. Kjellberg S., Holm A., Berguerand N., Sandén H., Schiöler L, Olsén M.F. et al. Impaired function in the lung periphery following COVID-19 is associated with lingering breathing difficulties. Physiol. Rep. 2024;12(2):e15918. DOI: 10.14814/phy2.15918.
Review
For citations:
Savushkina O.I., Muraveva E.S., Davydov D.V., Kryukov E.V. The influence of the criterion of abnormal DLco value on the prediction of impaired lung diffusion capacity after SARS-CoV-2 infection. Bulletin of Siberian Medicine. 2025;24(1):69-76. https://doi.org/10.20538/1682-0363-2025-1-69-76
Views:
164
Email this article 