The functional consequences in severe and critical covid-19 survivors - A pilot study.

PURPOSE: To perform pulmonary function tests (PFT) in severe COVID-19 survivors one and five months after hospital discharge in order to assess the lung function, as well to identify clinical characteristics and PFT parameters associated with worse cardiopulmonary exercise testing (CPET). MATERIAL AND METHODS: A prospective study included 75 patients with severe form of COVID-19. PFT was conducted one and five months after hospital discharge, in addition to CPET in a second assessment. Patients with a previous history of chronic respiratory diseases were excluded from our study. RESULTS: One month after hospital discharge, all examined patients had diffusion lung capacity for carbon-monoxide(DLco%) below the 80% of predicted values (in mean 58%), with 40% of patients having a restrictive pattern (total lung capacity(TLC) < 80%). In a repeated assessment after five months, pathological DLco% persisted in 40% of patients, while all other PFT parameters were normal. CPET showed reduced maximum oxygen consumption during exercise testing (VO2peak%) values in 80% of patients (in mean 69%), and exercise ventilatory inefficiency in 60%. Patients with VO2peak < 60% had significantly lower values of examined PFT parameters, both one and five months after hospital discharge. Patients with VO2peak% ≥ 60% had a significantly higher increase after the second assessment for Forced expiratory volume in 1st second (FEV1%), Forced expiratory volume in 1st second and forced vital capacity ratio (FEV1/FVC), DLco% and Diffusion lung capacity for carbon monoxide corrected for alveolar volume (DLco/VA). CONCLUSION: Significant functional abnormalities, according to PFT and CPET, was present both one and five months in severe COVID-19 survivors, thus emphasizing the importance of a comprehensive follow-up including both resting and dynamic functional assessment in these patients.

The Serbian version of the Epworth Sleepiness Scale.

PURPOSE: The Epworth Sleepiness Scale (ESS) is extensively used for evaluating daytime sleepiness in patients with sleep apnea-hypopnea syndrome (SAHS). The aim of this study was to translate and validate the ESS in the Serbian language. METHODS: The Serbian version of the ESS (ESSs) was administered to 112 patients with symptoms of sleep disorder breathing referred to Sleep Center of the Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia and 111 healthy controls. Test-retest reliability was tested in 19 healthy subjects. RESULTS: Patients referred to the Sleep center had significantly higher ESS scores compared to controls (9 vs. 4, p < 0.001). The difference was also present for each item separately, excluding item 5. The ESSs scores were significantly higher in patients with severe (median, 13.5; interquartile range (IQR), 10.3-17.8) compared to moderate (median, 9; IQR, 7.3-9.5; p = 0.005) and mild SAHS (median, 8; IQR, 5.5-9.7; p < 0.001). Item analysis demonstrated good internal consistency of the scale (Cronbach's alpha 0.88 in patients and 0.72 in healthy controls). Test-retest Spearman's correlation coefficient was 0.68 (p = 0.001). CONCLUSION: The Serbian version of the ESS demonstrated good internal consistency and test-retest reliability. The ESSs could be used for both clinical practice and research in Serbian population.