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Respiratory Complications in Patients with Severe Cases of COVID-19

Conducting a two-year study of respiratory function in COVID-19 patients at Cochin Hospital in Paris

Many patients with COVID-19 have been treated at Cochin Hospital, either in standard units for COVID patients or in intensive care units, depending on the severity of their respiratory symptoms. Some of these patients may experience long-term pulmonary complications. If this proves to be true, will these complications be proportional to the severity of the initial case? Professors Dinh-Xuan and Roche at Cochin Hospital will monitor the recovery of one hundred of these patients for 24 months. Their goal is to understand the mechanisms behind the evolution from initial lung damage to possible chronic illness, in order to identify risk factors and develop a prevention strategy.

Acute Respiratory Distress

While the SARS-CoV-2 virus is transmitted via the upper airways (nose, nasal cavities, mouth, pharynx and larynx), a certain percentage of patients develop viral pneumonia whose severity depends on how extensive it is in the lung and the degree of respiratory failure, resulting in hypoxemia (diminished blood oxygen levels). 

In the most serious cases, pneumonia-induced hypoxemia can lead to acute respiratory distress syndrome (ARDS). The medium- and long-term complications arising from this pneumonia are not known.

Given what we know about the physiopathology of COVID-19 and acute respiratory distress syndrome, it is possible that a new chronic illness linked to the coronavirus will emerge, and that a significant percentage of patients with COVID-19 may experience long-term respiratory complications, including developing chronic post-COVID respiratory failure. This percentage of patients could be as high as 25%, according to initial findings.

Monitoring Respiratory Function for Three Months

Professors Dinh-Xuan and Roche from Cochin Hospital aim to:

  • identify, quantify and classify anomalies in respiratory function in patients with severe cases of COVID-19 over the 24 months following their hospitalization in intensive care units and
  • study the underlying mechanisms causing these anomalies

More than 100 patients with covid-19 with respiratory disease who have been hospitalized at Cochin Hospital are being followed as part of this research. Very complete measurements of their respiratory function will be taken precisely every 3 months for 2 years after the onset of their symptoms.

The teams led by Professors Dinh-Xuan and Roche will particularly focus on airflow and volume in the lungs (spirometry) and oxygen and carbon dioxide exchanges between the air and the blood at the tissue level. 

The results of this study will make it possible to better understand, explore and treat long-term respiratory complications caused by viral infections that share characteristics with COVID-19, with or without acute respiratory distress.

How the Air Liquide Foundation is participating

The Foundation enables Prof. Dinh-Xuan and Prof. Roche to carry out their research work thanks to the funding of state-of-the-art equipment, including an expired NO measuring device, and the funding of the salary of a master's student dedicated to this study for 2 years.