Women at higher risk of functional respiratory complaints following a COVID-19 infection

In an observational study, a diverse range of respiratory issues was discovered in the aftermath of a COVID-19 infection that persisted beyond the acute infection. The prevalence appeared to be higher among women. 

According to previous research, prevalence of functional respiratory complaints (FRCs) in the general population is approximately 8%. “Early reports after the SARS-CoV-2 outbreak suggested that hyperventilation syndrome was overrepresented in patients recovering from COVID-19, therefore, the aim of our study was to assess the prevalence of FRCs in COVID-19 survivors and to identify possible associated factors,” said Prof. Thomas Gille (Université Sorbonne Paris Nord, France) [1]. To understand the prevalence of FRCs following COVID-19 and identify potential contributing factors, a retrospective, observational, monocentric study was conducted. A total of 169 patients, including 100 men, participated in the study.

“The study included individuals who underwent pulmonary function tests at our centre in 2021, approximately 6.1 months after their COVID-19 episodes,” said Prof. Gille. A comprehensive assessment involved the completion of the Nijmegen questionnaire (NQ) and the Dyspnoea-12 questionnaire (D-12), which explored both the physical and psychological dimensions of dyspnoea. The study population was divided into 2 groups: the FRCs+ group (NQ score ≥23) and the no-FRCs group (NQ score ≤22).

Out of 169 patients, 25% were classified in the FRCs+ group, indicating a substantial prevalence of post-COVID-19 respiratory issues. Notably, 36% of the women fell into this category compared with 17% of the men (see Figure). This stark sex difference was statistically significant (P=0.004), highlighting a notable predominance in the occurrence of FRCs in women. Despite the observed sex difference, there was no significant disparity in mean age or BMI between the 2 groups; mean age was 57.8 years and mean BMI was 28.9 kg/m².

The presence of FRCs was strongly correlated with both the physical and affective dimensions of dyspnoea, as shown by the NQ and D-12 scores. Neither the time elapsed since the COVID-19 episode nor the results of the pulmonary function tests proved to be predictive factors for an NQ score ≥23, indicating that the persistence of respiratory complaints was not directly related to the severity of the initial infection.

In his conclusion, Prof. Gille underlined the significantly higher prevalence of post-COVID-19 FRCs compared with the general population, with women being disproportionately affected. These respiratory issues appeared to be independent of demographic characteristics but strongly correlated with the physical and affective dimensions of dyspnoea.

Figure: Presence of functional respiratory complaints in the general population and 6 months after a COVID-19 infection in the presented study [1]

1. Gille T, et al. Prevalence and associated factors to post-COVID-19 functional respiratory complaints (FRCs) identified by the Nijmegen questionnaire. Abstract 4324, ERS 2023 Congress, 9–13 September, Milan, Italy.

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Posted on 29 October 202329 October 2023