Breath assessment at with post-tuberculosis patients suffered new coronavirus infection

Abstract

BACKGROUND: The possibility of mutual aggravation of post-tuberculosis and post-COVID respiratory pathologies requires additional consideration.

AIM: To study some subjective breathing parameters at patients with post-tuberculosis pulmonary residual changes after a new coronavirus infection recovering.

MATERIALS AND METHODS: The study included two groups: the main group — 14 patients with cured pulmonary tuberculosis, who had recovered from a new coronavirus infection, a comparison group — 52 patients with post-tuberculosis changes non-sick new coronavirus infection who were admitted to the tuberculosis sanatorium “Glukhovskaya” in 2020–2021. The severity of shortness of breath using the Modified Medical Research Council (mMRC) and Borg scales was assessed upon admission to the sanatorium and a month later.

Results: The mMRC scale was 1.5 ± 1.4 and 2.1 ± 0.2 and the Borg scale was 1.5 ± 1.4 and 2.9 ± 0.2 before treatment respectively in the main group and the comparison group. According to the mMRC scale initially 14.3 and 11.5% of patients with pulmonary tuberculosis and the comparison group did not complain of shortness of breath and 50% of pulmonary tuberculosis patients and 42.4% of the comparison group defined it as severe. After a month there were 3 or 4 points on the mMRC scale among pulmonary tuberculosis patients. In the comparison group 3-point shortness of breath decreased by 11.2 times most often indicated shortness of breath with 2 score. According to the Borg scale dyspnea was initially assessed as 3 points at 71.5% pulmonary tuberculosis patients. In the comparison group 67.3% patients had grade 3 dyspnea and 11.5% noted 4–6 grade shortness of breath. After a month the proportion of patients with mild shortness of breath at the pulmonary tuberculosis and comparison groups increased by 4.5 and 3.3 times, respectively, and the frequency of 3-grade shortness of breath decreased by 5 and 3.9 times.

CONCLUSIONS: Major post-tuberculosis changes, smoking and chronic obstructive pulmonary disease determine the severity of breathing discomfort to a greater extent than the experience of new coronavirus infection but rehabilitation treatment are leveled out these differences. It is advisable to study the state of the respiratory system at patients cured of pulmonary tuberculosis.

Keywords

tuberculosis / new coronavirus infection / residual post-tuberculosis changes / dyspnea / rehabilitation

References

[1] Ots ON, Chushkin MI, Struchkov PV. Impaired respiratory function of the lungs in patients with post-tuberculosis changes. Pul’monologiya. 2017;27(5):656–663. EDN: XNSQAH doi: 10.18093/0869-0189-2017-27-3-656-663

[2] Отс О.Н., Чушкин М.И., Стручков П.В. Нарушения респираторной функции легких у больных с посттуберкулезными изменениями // Пульмонология. 2017. Т. 27, № 5. С. 656–663. EDN: XNSQAH doi: 10.18093/0869-0189-2017-27-3-656-663

[3] Chushkin MI, Mandrykin YuV, Yartsev SS, et al. Quality of life in persons cured of pulmonary tuberculosis. Pul’monologiya. 2010;2:88–90. (In Russ.) EDN: MHWSNH

[4] Чушкин М.И., Мандрыкин Ю.В., Ярцев С.С., и др. Качество жизни у лиц, излеченных от туберкулеза легких // Пульмонология. 2010. № 2. С. 88–90. EDN: MHWSNH

[5] Allwood BW, van der Zalm MM, Amaral AFS, et al. Post-tuberculosis lung health: perspectives from the First International Symposium. Int J Tuberc Lung Dis. 2020;24(8):820–828. doi: 10.5588/ijtld.20.0067

[6] Allwood B.W., van der Zalm M.M., Amaral A.F.S., et al. Post-tuberculosis lung health: perspectives from the First International Symposium // Int J Tuberc Lung Dis. 2020. Vol. 24, N 8. P. 820–828. doi: 10.5588/ijtld.20.0067

[7] Visca D, Amdrosio LD, Centis R, et al. Post-TB disease: a new topic for investigation — and why it matters. Int J Tuberc Lung Dis. 2021;25(4):258–261. doi: 10.5588/ijtld.21.0040

[8] Visca D., Amdrosio L.D., Centis R., et al. Post-TB disease: a new topic for investigation—and why it matters // Int J Tuberc Lung Dis. 2021. Vol. 25, N 4. P. 258–261. doi: 10.5588/ijtld.21.0040

[9] van Kampen SC, Wanner A, Edwards M, et al. International research and guidelines on posttuberculosis chronic lung disorders: a systematic scoping review. BMJ Glob Health. 2018;3:e000745. doi: 10.1136/bmjgh-2018-000745

[10] van Kampen S.C., Wanner A., Edwards M., et al. International research and guidelines on posttuberculosis chronic lung disorders: a systematic scoping review // BMJ Glob Health. 2018. Vol. 3. P. e000745. doi: 10.1136/bmjgh-2018-000745

[11] Migliori GB, Marx FM, Ambrosin N, et al. Clinical standards for the assessment, management and rehabilitation of post-TB lung disease Int J Tuberc Lung Dis. 2021;25(10):797–813. doi: 10.5588/ijtld.21.0425

[12] Migliori G.B., Marx F.M., Ambrosin N., et al. Clinical standards for the assessment, management and rehabilitation of post-TB lung disease // Int J Tuberc Lung Dis. 2021. Vol. 25, N 10. P. 797–813. doi: 10.5588/ijtld.21.0425

[13] Soriano JB, Murthy S, Marshall JC, et al. A clinical case definition of post COVID-19 condition by a Delphi consensus. Lancet Infect Dis. 2022;22(4):e102–e107. doi: 10.1016/S1473-3099(21)00703-9

[14] Soriano J.B., Murthy S., Marshall J.C., et al. A clinical case definition of post COVID-19 condition by a Delphi consensus // Lancet Infect Dis. 2022. Vol. 22, N 4. P. e102–e107. doi: 10.1016/S1473-3099(21)00703-9

[15] Chernyak AV, Mustafina MKh, Naumenko ZhK, et al. Dynamics of functional in the respiratory system after COVID-19-associated lung injury at one year after hospital discharge Pul’monologiya. 2023;33(5):611–621. EDN: ITDWZT doi: 10.18093/0869-0189-2023-33-5-611-621

[16] Черняк А.В., Мустафина М.Х., Науменко Ж.К., и др. Динамика функциональных изменений системы дыхания у пациентов, перенесших НКИ-ассоциированное поражение легких, через 1 год после выписки из стационара // Пульмонология. 2023. Т. 33, № 5. С. 611–621. EDN: ITDWZT doi: 10.18093/0869-0189-2023-33-5-611-621

[17] Temporary guidelines “Medical rehabilitation for new coronavirus infection (COVID-19). Version 3 (01.11.2022)” Available from: https://www.consultant.ru/document/cons_doc_LAW_358669/76f4d9e5aebc059b3c9a26fb6e57e2951afc8aca/. Accessed: 07 May, 2022. (In Russ.)

[18] Временные методические рекомендации «Медицинская реабилитация при новой коронавирусной инфекции (COVID-19). Версия 3 (01.11.2022)» [Электронный ресурс]. Режим доступа: https://www.consultant.ru/document/cons_doc_LAW_358669/76f4d9e5aebc059b3c9a26fb6e57e2951afc8aca/. Дата обращения: 07.05.2024.

[19] Savushkina OI, Zaitsev AA, Kryukov EV, et al. Functional disorders of the respiratory system after a new coronavirus infection. News of the Russian Military Medical Academy. 2022;41(3):315–323. EDN: VWGNYU doi: 10.17816/rmmar108659

[20] Савушкина О.И., Зайцев А.А., Крюков Е.В., и др. Функциональные нарушения системы дыхания после перенесенной новой коронавирусной инфекции // Известия Российской Военно-медицинской академии. 2022. Т. 41, № 3. С. 315–323. EDN: VWGNYU doi: 10.17816/rmmar108659

[21] American Thoracic Society. Dyspnea: mechanisms, assessment, and management. Consensus Statement. Am J Respir Crit Care Med. 1999;159(1):321–340. doi: 10.1164/ajrccm.159.1.ats898

[22] American Thoracic Society. Dyspnea: mechanisms, assessment, and management. Consensus Statement // Am J Respir Crit Care Med. 1999. Vol. 159, N 1. Р. 321–340. doi: 10.1164/ajrccm.159.1.ats898

[23] Chushkin MI, Ots ON, Mandrykin SYu, et al. Six-minute walk test and its correlation with quality of life, external respiratory function in patients with post-tuberculosis changes. Pul’monologiya. 2013;2:69–73. EDN: QIKWZN

[24] Чушкин М.И., Отс О.Н., Мандрыкин С.Ю., и др. Тест с шестиминутной ходьбой и его корреляция с качеством жизни, функцией внешнего дыхания у больных с посттуберкулезными изменениями // Пульмонология. 2013. № 2. С. 69–73. EDN: QIKWZN

[25] Korelin VK, Ammer MK. Function of external respiration in patients with post-tuberculosis pneumosclerosis. Problems of tuberculosis. 1975;2:46–49. (In Russ.)

[26] Корелин В.К., Аммер М.К. Состояние функции внешнего дыхания у лиц с метатуберкулезными изменениями в легких // Проблемы туберкулеза. 1975. № 2. С. 46–49.

[27] Kovalenko AM. External respiration function in patients with post-tuberculosis changes. Problems of tuberculosis. 1975;5:47–50.

[28] Коваленко А.М. Функция внешнего дыхания у больных с посттуберкулезными изменениями // Проблемы туберкулеза. 1975. № 5. 47–50.

[29] Vysokova TM, Deev AD, Dukarsky BG. Ventilation and gas exchange functions of the lungs after recovery from tuberculosis. Problems of tuberculosis. 1976;9:26–30.

[30] Высокова Т.М., Деев А.Д., Дукарский Б.Г. Вентиляционная и газообменная функции легких после излечения от туберкулеза // Проблемы туберкулеза. 1976. № 9. С. 26–30.

[31] Lehmann A, Gysan M, Bernitzky D, et al. Comparison of pulmonary function test, diffusion capacity, blood gas analysis and CT scan in patients with and without persistent respiratory symptoms following COVID-19. BMC Pulm Med. 2022;22:196. doi: 10.1186/s12890-022-01987-z

[32] Lehmann A., Gysan M., Bernitzky D., et al. Comparison of pulmonary function test, diffusion capacity, blood gas analysis and CT scan in patients with and without persistent respiratory symptoms following COVID-19 // BMC Pulm Med. 2022. Vol. 22. P. 196. doi: 10.1186/s12890-022-01987-z

[33] Abdullaeva GB, Avdeev SN, Fominykh EV, et al. Assessment of long-term clinical and functional changes in patients who have suffered severe COVID-19-associated lung damage. Pul’monologiya. 2023;33(4):461–471. EDN: LQHHJL doi: 10.18093/0869-0189-2023-33-4-461-471

[34] Абдуллаева Г.Б., Авдеев С.Н., Фоминых Е.В., и др. Оценка отда ленных клинико-функциональных изменений у пациентов, перенесших тяжелое COVID-19-ассоциированное поражение легких // Пульмонология. 2023. Т. 33, № 4. С. 461–471. EDN: LQHHJL doi: 10.18093/0869-0189-2023-33-4-461-471

[35] Kovlen DV, Abuseva GR, Khozyainova SS, et al. Rehabilitation of patients who have suffered a new coronavirus infection COVID-19 in the second and third stages. News of the Russian Military Medical Aca demy. 2022;41(3):243–249. EDN: TYKTAQ doi: 10.17816/rmmar109250

[36] Ковлен Д.В., Абусева Г.Р., Хозяинова С.С. и др. Реабилитация пациентов, перенесших новую коронавирусную инфекцию COVID-19, на втором и третьем этапах // Известия Российской Военно-медицинской академии. 2022. Т. 41, № 3. С. 243–249. EDN: TYKTAQ doi: 10.17816/rmmar109250

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