Suggestions for lung function testing in the context of COVID-19

Manlio Milanese; Angelo Guido Corsico; Salvatore Bellofiore; Laura Carrozzi; Fabiano Di Marco; Bruno Iovene; Luca Richeldi; Antonio Sanna; Pierachille Santus; Mario Schisano; Nicola Scichilone; Carlo Vancheri; Isa Cerveri; SIP (Italian Respiratory Society)

doi:10.1016/j.rmed.2020.106292

Suggestions for lung function testing in the context of COVID-19

Respir Med. 2021 Feb:177:106292. doi: 10.1016/j.rmed.2020.106292. Epub 2020 Dec 31.

Affiliations

¹ SSD Pneumology ASL2 Savonese, Savona, Italy.
² UOC Pneumology, Department of Medical Sciences and Infectious Diseases, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Internal Medicine and Medical Therapy, University of Pavia, Italy.
³ Ambulatorio di Pneumology and Respiratory Physiopathology, Thoracic Surgery Department, AOU Policlinico - Vittorio Emanuele, Catania, Italy.
⁴ Pneumology Department, University Teaching Hospitals Pisa, Dept. of Surgical, Medical, Molecular Pathology, and Critical Care, University of Pisa, Italy.
⁵ Department of Health Sciences, University of Milan, Pneumology, ASST Papa Giovanni XXIII, Bergamo, Italy.
⁶ Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
⁷ Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Catholic University of the Sacred Heart, Rome, Italy.
⁸ Central Tuscany Azienda USL, SOS Pneumology and Bronchial Endoscopy, Ospedale San Jacopo (St. James Hospital), Pistoia, Italy.
⁹ Department of Biomedical and Clinical Sciences (DIBIC), University of Milan, Division of Respiratory Diseases, "L. Sacco" University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy.
¹⁰ Territorial Pneumology ASP 8, Syracuse, Italy.
¹¹ Pneumology Unit, Department of Maternal-Infant Health, Internal Medicine Promotion and Excellence Specialists "G. D'Alessandro", University of Palermo, Italy.
¹² "Regional Reference Centre for Rare Lung Diseases." A.O.U. "Policlinico - Vitt. Emanuele", Department of Clinical and Experimental Medicine, University of Catania, Italy.
¹³ Department of Internal Medicine and Medical Therapy, University of Pavia, Italy. Electronic address: icerveri@smatteo.pv.it.

Abstract

The 2019 coronavirus disease (COVID-19) pandemic is currently a challenge worldwide. Due to the characteristics of lung function tests, the risk of cross infection may be high between health care workers and patients. The role of lung function testing is well defined for the diagnosis of various diseases and conditions. Lung function tests are also indispensable in evaluating the response to medical treatment, in monitoring patient respiratory and systemic pathologies, and in evaluating preoperative risk in cardiothoracic and major abdominal surgeries. However, lung function testing represents a potential route for COVID-19 transmission, due to the aerosol generated during the procedures and the concentration of patients with pulmonary diseases in lung function laboratories. Currently, the opportunities for COVID-19 transmission remain partially unknown, and data are continuously evolving. This review provides useful information on the risks and recommendations for lung function testing, which have varied according to the phase of the pandemic. This information may support national and regional boards and the health authorities to which they belong. There is a need for rapid re-opening of lung function laboratories, but maximum safety is required in the COVID-19 era.

Keywords: COVID-19; Indications; Lung function testing; warnings.

Publication types

Review