Structural, functional and inflammatory assessment of the lungs in patients after infection with SARS-CoV-2 without previous lung disease

Abstract

A new Coronavirus (SARS-CoV-2) is the etiological agent of the disease, called COVID-19. It is causing thousands of mild, moderate and severe infections worldwide and is the cause of the largest pandemic in the last 50 years. We do not know how many people have been infected by SARS-CoV-2, because many are asymptomatic, nor do we understand why some individuals have mild symptoms while others have severe illness. We also do not understand why some individuals with mild and moderate forms may indeed have great acute pulmonary injury, but nonetheless would need no ICU admission, with clinical recovery being sufficient. Furthermore, it is well known that SARS-CoV-2 fixates, multiplies and disseminates greatly in the pulmonary airways, which could cause sequelae even in mild and moderate forms of COVID-19Objective: To verify if children and adolescents who had mild, moderate and severe forms, and adults with mild and moderate forms of COVID-19, present changes in lung structure, lung function and clinical and psychological impact on quality of life, resilience, anxiety and depression, after six months of the disease. Methods: An observational, analytical, prospective cross-sectional work will be researched with patients who had COVID-19. The following tools will be used to evaluate the structure, pulmonary function and clinical and psychological impact of the disease: high resolution computed tomography of the chest, chest ultrasonography; spirometry, impulse oscillometry system (IOS), plethysmography, measurement of Fractional exhaled nitric oxide (FeNO), measurement of hemoglobin transcutaneous oxygen saturation, manuvacuometry, six-minute walk test (6MWT) and standardized tests on quality of life, depression and anxiety. Numerical variables will be analyzed by obtaining central tendency measures as mean and median, as well as measures of variability as standard deviation and variance. All statistical tests that are used will be performed considering a 5% significance level (pd0,05). The project is being submitted to the research institution's Ethics Committee. The main goal of this study will be to verify pulmonary alterations in subjects who were infected by SARS-CoV-2 and developed COVID-19. We believe that we will be able to find alterations, which will be manageable, to improve the health and quality of life of such individuals. The research may provide further understanding of pulmonary involvement and temporal sequelae that are resulted by the inflammatory response caused by COVID-19, even in mild cases. Based on this understanding, we intend to develop strategies to delay and minimize sequelae from COVID-19, reducing the deterioration of pulmonary structure and function. (AU)