Abstract
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 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 cardio-pulmonary exercise testing (CPET).
Findings In the COMEBAC cohort, 37 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-minute 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, 7/21 patients had significant FRCs. Based on CPET, dysfunctional breathing was identified in 12/21 patients, 5/21 had normal CPET, 3/21 had deconditioning and 1/21 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.
Funding Assistance Publique-Hôpitaux de Paris.
Footnotes
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Conflict of Interest: Antoine Beurnier reports personal fees from Sanofi, personal fees from Astrazeneca, outside the submitted work.
Conflict of Interest: Laurent Savale reports personal fees and non-financial support from Janssen & Janssen, personal fees and non-financial support from MSD, grants, personal fees and non-financial support from GSK, outside the submitted work.
Conflict of Interest: Xavier Jaïs reports grants and personal fees from Janssen, grants and personal fees from MSD, grants from Bayer, grants from GSK, outside the submitted work.
Conflict of Interest: Thomas Gille reports personal fees from ROCHE S.A.S., other from OXYVIE (oxygen provider), other from VIVISOL France (oxygen provider), other from MENANIRI France, outside the submitted work.
Conflict of Interest: Olivier Sitbon reports grants from Acceleron, AOP Orphan, Janssen, GSK, MSD; consulting fees from Altavant, Gossamer Bio, Janssen, MSD; lecture honoraria from AOP Orphan, Janssen, Ferrer, MSD; participation on advisory boards for Acceleron, Altavant, Gossamer Bio, Janssen, MSD, Ferrer; outside the submitted work.
Conflict of Interest: Marc Humbert reports grants from Acceleron, AOP Orphan, Janssen, Merck, Shou Ti; consulting fees from Acceleron, Aerovate, Altavant, AOP Orphan, Bayer, Chiesi, Ferrer, Janssen, Merck, MorphogenIX, Shou Ti, United Therapeutics; lecture honoraria from Janssen, Merck; advisory board participation for Acceleron, Altavant, Janssen, Merck, United Therapeutics; outside the submitted work.
Conflict of Interest: David Montani reports grants from Acceleron, Janssen, Merck; consulting fees from Acceleron; lecture honoraria from Bayer, Janssen, Merck; outside the submitted work.
Conflict of Interest: All other authors have nothing to disclose.
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- Received January 30, 2023.
- Accepted February 6, 2023.
- Copyright ©The authors 2023
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