Lung Damage Caused by SARS-CoV-2 Pneumonia (COVID-19)
Condition: COVID; Pneumonia, Viral; Barotrauma; Interstitial Lung Disease; Bronchiectasis Adult; Emphysema
MeSH terms: Pneumonia; Pneumonia, Viral; Lung Diseases; Lung Diseases, Interstitial; Bronchiectasis; Emphysema; Barotrauma
Study type: Observational

Summary: 
      Pneumonia is a recurrent element of COVID-19 infection, it is often associated with
      development of respiratory failure and patients frequently need various degrees of oxygen
      therapy up to non invasive ventilation (NIV-CPAP) and invasive mechanical ventilation (IMV).

      Main purpose of this study is to evaluate with non invasive clinical instruments
      (pletysmography, Diffusion lung capacity for carbon monoxide -DLCO-, six minute walking test
      and dyspnea scores) and radiological tools (chest X-ray and chest CT scan) the development of
      medium-to-long term pulmonary sequelae caused by SARS-CoV-2 pneumonia.
    

Detailed description: 
      SARS-CoV-2 related disease started in December 2019 in the Chinese city of Wuhan, rapidly
      spread and became an international health emergency.

      Pneumonia is a frequent element of COVID-19, its pathogenic mechanisms are not entirely known
      and some patients develop various degrees of respiratory failure and need oxygen therapy up
      to NIV-CPAP) and IMV.

      Some pathology studies in COVID-19 pneumonia show ARDS-like lesions associated to
      inflammatory reaction. It is known that pulmonary inflammatory damage can lead to fibrotic
      sequelae or to the development of pulmonary emphysema.

      The main target of the study is to use non invasive methods (pletysmography, DLCO assessment,
      six minute walking test and dyspnea scores) and radiological tools (chest X-ray and chest CT
      scan) to identify pulmonary sequelae in patients hospitalised because of respiratory failure
      in COVID-19 pneumonia.

      Study design: multicentre observational cohort study. Patients will be divided in three arms
      according to maximum ventilatory/oxygen support received during hospital stay:

        1. patients who received only oxygen therapy

        2. patients who received non invasive ventilation (NIV-CPAP)

        3. patients who received invasive mechanical ventilation (IMV)

      All patients undergo a clinical evaluation at 6 months from hospital discharge (T1) and a
      second clinical evaluation at 12 months from hospital discharge (T2).

      During (T1) patients undergo spirometry with pletysmography and DLCO assessment, six minute
      walking test, standard chest X-ray, arterial blood gas analysis if SaO2 < 93% in room air,
      dyspnea score and presence and extension of lung sounds at pulmonary auscultation.

      During (T2) patients will undergo spirometry with pletysmography and DLCO assessment, six
      minute walking test, High Resolution CT scan (HRTC) of the thorax, arterial blood gas
      analysis if SaO2 < 93% in room air, dyspnea score and presence and extension of lung sounds
      at pulmonary auscultation).
    

Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Patients with respiratory failure (P/F < 300) due to SARS-CoV-2 pneumonia