Respiratory Functions in the Follow-Up of Children with COVID-19 Infection

Introduction or Background: The long-term effects of COVID-19 infection on the respiratory system in children are not yet known. Aims and Objectives: To determine the long-term effects of COVID-19 infection on the respiratory system of children by evaluating pulmonary function tests. Methods: In this multicenter study, COVID-19 PCR positive children(≥6years) were evaluated prospectively with pulmonary function tests(spirometry,plethysmography and CO diffusion) at 3rd and 6th months follow-up. The results were evaluated retrospectively based on clinical symptoms,physical examination findings,radiological and laboratory tests of the patients in the acute phase of the infection. Results: At 3rd month evaluation of 270 COVID-19 PCR positive pediatric patients,mean FEV1 96.85±16.84%,FVC 96.06±16.84% were found;at 6th month,mean FEV1 100,03±15.98%,FVC 100.62±16.87. At the 3rd month,statistically significant differences were found between FEV1<80%(n:28),FEV1>80%(n:242) groups due to the presence of additional diseases(p<0.001),having respiratory(p=0.006) and cardiovascular(p=0.004) system pathological examination findings,interlobular septal thickening(p=0.020) on thorax CT,high level of CRP(p=0.032),IL-6(p=0.048),ferritin(p=0,020) during the infection period. Having COVID-19 pneumonia was found to be non-effective on spirometric test results. No difference was found between the 3rd and 6th month spirometry results of the same patient. Conclusion: After recovery of COVID-19 infection, children who have additional diseases, and pathological examination and radiological findings during the infection period, may have functional respiratory changes; so they should be monitored with pulmonary function tests.