A test for the diagnosis and follow-up of post-COVID-19 disease symptoms: Diffusion test (DLCO) Why is the Lung Diffusion Test (DLCO) performed?
Since the COVID-19 pandemic that started in 2019, severe As long-term complaints, sometimes persistent diseases are reported in those who have had or have had moderate to severe COVID-19, the aggregated results; It has been described as a “Post Acute COVID-19 syndrome” (post-covid disease symptoms). While COVID-19 was first thought to cause damage to the lungs, it is now understood that it damages many organs at the same time. In this case, many diseases caused by damaged organs are seen together, and their diagnosis and treatment remain unclear. Describing the post-covid-19 symptoms that our body is affected by, discussing the diagnostic methods that reveal the signs and symptoms of the disease after COVID-19.
Problems Encountered in the Diagnosis and Treatment of Post-COVID-19 Diseases:
In those with COVID-19, persisting for 3-4 months after the onset of the disease:
- Extreme fatigue,
- Decreased quality of life,
- Breathing dyspnea,
- Long-lasting dry cough
- Backward runny nose
- Dizziness
- Sleep disturbances
Patients who have health problems such as restlessness and strangeness in their behavior apply to health centers. In health centers with increasing density, these “PostCOVID-19 syndrome” complaints are often considered as general discomfort conditions without detailed examinations, and they are tried to be corrected by giving general treatments to relieve complaints.
Illnesses after COVID-19: COVID-19 disease If the symptoms continue for 4-6 weeks after the onset of symptoms (such as PCR +, high fever, headache, loss of smell, cough, muscle aches, sore throat), it should be considered as “post covid-19 syndrome”.
Clinical features of diseases developing after COVID-19:
- Fatigue,
- shortness of breath, feeling of tightness in the chest si
- Fatigue to the point of exhaustion
- Brain confusion, dizziness,
- Muscle weakness, inability to lift arm, leg, head
- Headache,
- Continued loss of taste and smell
- cough
- Depressed state
- Mild high fever (37.3C-37.5C)
- Palpitations
- Dizziness,
- Muscle pains-joint pains
Causes:
Systemic inflammation: In severe infections, or after injuries, the body reacts with the immune system (immune system) to renew itself and correct the infection. This is called a systemic inflammation reaction. When the reaction of the immune system cells is excessive (cytokine storm), the body's healthy cells and organs begin to be damaged and fragmented. If the immune system cannot stop this excessive inflammation (cytokine storm), a situation called systemic inflammation occurs and many organs and cells are damaged, and related diseases and complaints occur.
Affected organ – systems of the body:
Post Acute COVID-19 syndrome is a condition in which multiple organs and systems are affected. Since the most commonly affected respiratory, cardiovascular (cardio-vascular) and hemapoitic (blood-coagulation) systems are damaged, their destruction becomes the cause of many diseases and many related complaints. In addition to these, urinary (kidney) and neuropsychiatric (nervous system) organs and systems may also be affected. The thin layer between the capillary blood vessels may be damaged, coagulation (embolism) in the capillaries may lead to blockages, and the passage of oxygen to the blood may decrease. Symptoms such as fatigue, shortness of breath, palpitation, cough occur. Pulmonary fibrosis may develop. (hardening of the lung structure by losing its functions, alveolar destruction)
LUNG DIFFUSION TESTS (DLCO) ;
A very important test in the diagnosis and follow-up of Lung and Heart abnormalities after COVID-19 In patients, damage can be seen in which lung and heart functions deteriorate later on. Post-COVID-19, lung sequelae, pulmonary enbolism, heart failure Symptoms such as heart muscle inflammation (myocarditis), shortness of breath, fatigue, palpitations may occur. Lung Diffusion Test (DL CO) This test measures how well gases such as oxygen pass from your lungs to your blood.
DL CO test results mean; Diffusion Capacity Tests (DLCO), which show how your alveoli are affected, tell your doctor if your alveoli are damaged. The carbon dioxide of the dirty blood in the very thin capillaries in the alveolar membrane passes into the alveoli, and the oxygen of the air in the alveoli passes into the blood. If the alveolar wall is damaged in diseases, oxygen transmission to the blood may decrease.
Which factors affect your diffusion capacity (DLCO):
There are three factors that determine our DLCO:
one. The amount of lung tissue in contact with the blood vessels (capillaries). This is called the lung-blood interface.
2. The thickness of the lung alveolar wall. (The thicker the wall, the lower the diffusion capacity)
3. The pressure differences between the gas in the alveoli and the gas in your blood.
How do we measure the Diffusion Capacity? DLCO TEST:
Your doctor will explain to you in detail what will be done during the test and will give you the operation commands as follows: Nose clip will be attached (air cannot escape from your nose while breathing in) You will insert the mouthpiece into your mouth. You will take a deep breath. Hold your breath for at least 10 seconds. Then you will exhale and exhale rapidly again. How it works: When you breathe through the mouthpiece, you inhale a test gas mixture (methane, carbon monoxide, oxygen gas mixture) and when you exhale, the device calculates the rate of passage of gases from the alveoli to the blood by taking sample measurements from the gases you breathe. Decreases in DLCO results show early signs of damage to the alveoli (lung air sacs) and capillaries. Prevention of permanent fibrosis and micro-local hypoxia (lack of oxygen), and initiating cortisone and oxygen treatments immediately will help in their decisions.
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