AVALIAÇÃO INSTRUMENTAL DA FUNÇÃO PULMONAR NO PÓS-COVID-19 TARDIO: UMA REVISÃO INTEGRATIVA
Palavras-chave:
Covid-19, espirometria, avaliação respiratória, testes respiratóriosResumo
Introdução: Após os impactos significativos da pandemia causada pelo vírus SARS-CoV-2, é de extrema importância determinar a abordagem mais eficaz para a avaliação da função pulmonar em pacientes que enfrentaram a doença, bem como identificar os instrumentos mais utilizados para ela. Objetivo: Analisar os dispositivos usados na avaliação da função pulmonar em pacientes no pós Covid-19 tardio. Método: Trata-se de uma revisão integrativa da literatura científica acerca desse tema. Para o levantamento de dados foram utilizados os bancos de dados Biblioteca Virtual de Saúde (BVS), PubMed Unique Identifier (PubMed), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Scientific Electronic Library Online (SciELO). Foram selecionados artigos nos idiomas Inglês, Português e Espanhol, publicados nos últimos 5 anos. Resultado: Foram analisados 22 artigos, que revelaram uso da espirometria, em 22 estudos, mostrou-se fundamental para identificar padrões ventilatórios, embora, em muitos casos, os valores médios de FVC e FEV1 estivessem dentro da normalidade. A capacidade de difusão pulmonar (DLCO), avaliada em 12 artigos, foi consistentemente o marcador de disfunção mais comum e persistente. Outros instrumentos, como o Teste de Caminhada de Seis Minutos (TC6M), a manovacuometria para avaliar a força muscular respiratória, e a oscilometria de impulso (IOS), também foram utilizados para diagnosticar a limitação funcional e a disfunção de pequenas vias aéreas, respectivamente. Conclusão: Os instrumentos mais utilizados para avaliar a função pulmonar são a espirometria, a DLCO, a Manovacuometria, a IOS e o TC6M.
Referências
¹KARADUMAN, Emre; BOSTANCI, Özgür; BİLGİÇ, Sait. A follow-up study on respiratory outcomes, quality of life and performance perception of SARS-CoV-2 primary and reinfection in elite athletes: A 9-month prospective study. European Journal of Sport Science, v. 24, p. 964–974, 2024.
²ASIJA, Mohini; et al. The Assessment of Functional Status Among COVID-19 Patients at Three Months Using Pulmonary Function Tests. Cureus, v. 16, n. 5, p. e61221, 2024. DOI: 10.7759/cureus.61221.
³KUODI, P.; et al. Characterization of post-COVID syndromes by symptom cluster and time period up to 12 months post-infection: A systematic review and meta-analysis. International Journal of Infectious Diseases, v. 134, p. 1-7, 2023. DOI: 10.1016/j.ijid.2023.05.003.l
⁴GÜLHAN, Pınar Y.; et al. An assessment of post-COVID-19 infection pulmonary functions in healthcare professionals. American Journal of Infection Control, Düzce: Elsevier, v. 50, p. 1125-1132, 2022.
⁵DEL CORRAL, Tamara; et al. Home-based respiratory muscle training on quality of life and exercise tolerance in long-term post-COVID-19: Randomized controlled trial. Annals of Physical and Rehabilitation Medicine, Madrid: Elsevier Masson SAS, v. 66, p. 101709, 2023.
⁶ FORTINI, Alberto; ROSSO, et al. One-year evolution of DLCO changes and respiratory symptoms in patients with post COVID-19 respiratory syndrome. Infection, Heidelberg: Springer-Verlag, v. 50, p. 513-517, 2022. Disponível em: https://doi.org/10.1007/s15010-022-01755-5.
⁷MAURITS, R. Denny; et al. Physical activity improves health-related quality of life, 6MWT, and VO2 peak before and during COVID-19 in patients with heart failure: A meta-analysis. Semergen, v. 49, n. 8, p. 102039, 2023. Disponível em: 10.1016/j.semerg.2023.102039.
⁸PAGE, Matthew J. et al. A declaração PRISMA 2020: diretriz atualizada para relatar revisões sistemáticas. Epidemiologia e Serviços de Saúde, Brasília, v. 31, n. 2, p. e2022107, 2022. Disponível em: http://scielo.iec.gov.br/scielo.php?script=sci_arttext&pid=S1679-49742022000201700&lng=pt&nrm=iso. Acesso em: 1 set. 2025.
⁹NÚÑEZ-FERNÁNDEZ, Marta; et al. Evolution and long-term respiratory sequelae after severe COVID-19 pneumonia: nitric oxide diffusion measurement value. Respiratory Research, Vigo: Springer Nature, v. 24, p. 48, 2023.
¹⁰WU, Qian; et al. A Follow-Up Study of Lung Function and Chest Computed Tomography at 6 Months after Discharge in Patients with Coronavirus Disease 2019. Canadian Respiratory Journal, v. 2021, ID do Artigo 6692409, 7 p., 2021. Disponível em: https://doi.org/10.1155/2021/6692409.
¹¹SCARAMUZZO, G. et al. Long-term dyspnea, regional ventilation distribution and peripheral lung function in COVID-19 survivors: a 1-year follow up study. BMC Pulmonary Medicine, v. 22, n. 408, 2022. Disponível em: https://doi.org/10.1186/s12890-022-02214-5.
¹²BJÖRSELL, Tove; et al. Risk factors for impaired respiratory function post-COVID-19: A prospective cohort study of nonhospitalized and hospitalized patients. Journal of Internal Medicine, v. 293, n. 5, p. 600-614, maio 2023. Disponível em: https://doi.org/10.1111/joim.13614.
¹³LERUM, Tøri Vigeland; et al. A prospective study of pulmonary outcomes and chest computed tomography in the first year after COVID-19. ERJ Open Research, v. 9, n. 00575-2022, 2023.
¹⁴NAKSHBANDI, Gizal; et al. Home monitoring of lung function, symptoms and quality of life after admission with COVID-19 infection: The HOMECOMIN' study. Respirology, v. 27, n. 7, p. 501–509, 2022. Disponível em: https://doi.org/10.1111/resp.14262.
¹⁵PÁEZ-MORA, Carlos D.; et al. Changes in lung function and dyspnea perception in Colombian Covid-19 patients after a 12-week pulmonary rehabilitation program. PLoS ONE, Valledupar: Public Library of Science, v. 19, n. 11, p. e0300826, 2024.
¹⁶SÁNCHEZ-MILÁ, Zacarías; et al. Effectiveness of a respiratory rehabilitation program including an inspiration training device versus traditional respiratory rehabilitation: a randomized controlled trial. PeerJ, v. 11, e16360, 2023. Disponível em: 10.7717/peerj.16360.
¹⁷SOUSA, Pedro Henrique Borges; et al. Analysis of pulmonary function in post-Covid-19 patients at a university hospital. Medicina (Ribeirão), v. 56, n. 3, p. e-206263, 2023.
¹⁸ BRETAS, Daniel Cruz; et al. Lung function six months after severe COVID-19: Does time, in fact, heal all wounds? Brazilian Journal of Infectious Diseases, Belo Horizonte: Sociedade Brasileira de Infectologia, v. 26, n. 3, p. 102352, 2022
¹⁹SOUSA, Barbara Galdino de; et al. Persistence of symptoms and lung function in mild cases of COVID-19 six months after infection: a cross-sectional study. Jornal Brasileiro de Pneumologia, v. 50, n. 1, p. e20230305, 2024. Disponível em: https://dx.doi.org/10.36416/1806-3756/e20230305.
²⁰GOBBI, Michele; et al. Skeletal Muscle Mass, Sarcopenia and Rehabilitation Outcomes in Post-Acute COVID-19 Patients. Journal of Clinical Medicine, v. 10, n. 23, p. 5623, 2021. Disponível em: https://doi.org/10.3390/jcm10235623.
²¹CORRAL, Tamara del; et al. Home-based respiratory muscle training on quality of life and exercise tolerance in long-term post-COVID-19: Randomized controlled trial. Annals of Physical and Rehabilitation Medicine, v. 66, p. 101709, 2023.
²²TELLES, Arturo Cortez; et al. Pulmonary function and functional capacity in COVID-19 survivors with persistent dyspnoea. Respiratory Physiology & Neurobiology, v. 288, p. 103644, 2021.
²³NJOETEN, Kiri Lovise; et al. Relationship between exercise capacity and fatigue, dyspnea, and lung function in non-hospitalized patients with long COVID. Physiological Reports, Bergen: Wiley Periodicals LLC, v. 11, e15850, p. 1-12, 2023. Disponível em: https://doi.org/10.14814/phy2.15850.
²⁴SAHIN, Mustafa Engin. Relation of impulse oscillometry and spirometry with quantitative thorax computed tomography after COVID-19 pneumonia. Revista da Associação Médica Brasileira, v. 69, n. 5, p. e20221427, 202
²⁵LOPES, Agnaldo José; et al. Small airway dysfunction on impulse oscillometry and pathological signs on lung ultrasound are frequent in post-COVID-19 patients with persistent respiratory symptoms. PLOS ONE, v. 16, n. 11, p. e0260679, 2021. Disponível em: 10.1371/journal.pone.0260679.
