Correlation between Pneumonia Severity and Pulmonary Complications in Middle East Respiratory Syndrome

Park, Wan Beom; Jun, Kang Il; Kim, Gayeon; Choi, Jae-Phil; Rhee, Ji-Young; Cheon, Shinhyea; Lee, Chang Hyun; Park, Jun-Sun; Kim, Yeonjae; Joh, Joon-Sung; Chin, Bum Sik; Choe, Pyeong Gyun; Bang, Ji Hwan; Park, Sang-Won; Kim, Nam Joong; Lim, Dong-Gyun; Kim, Yeon-Sook; Oh, Myoung-don; Shin, Hyoung-Shik

The pulmonary function test, a standardized 6-minute walk test, and chest computed tomography (CT) were performed 1 year after MERS-CoV infection. The pulmonary function tests included total lung capacity (TLC), forced volume vital capacity (FVC), forced expiratory volume in 1 second (FEV 1 ), and diffusing capacity of the lung for carbon monoxide (DLCO). All pulmonary function values were presented as predicted percentage considering age, sex, height, body weight, and race. Radiological sequelae were scored as the number of involved lung segments (total score = 19) on chest CT that were suspected to be post-inflammation sequelae, including sub-segmental atelectasis, ground glass opacity, and consolidation by a radiologist. 10 Emphysema, sequelae of tuberculosis, and bronchiectasis were excluded. Severe pneumonia was defined as the patient requiring oxygen therapy, mild pneumonia was defined as the patient presenting with infiltration on chest X-ray but not requiring oxygen therapy, and no pneumonia was defined as the patient without radiographic evidence of pneumonia. 11 Linear regression or linear by linear association was used to evaluate the association between the severity of pneumonia and continuous or categorical variables, as appropriate. The correlation between pneumonia severity and pulmonary function or radiological sequelae was evaluated using a multivariable linear regression model including age, sex, underlying lung diseases, and smoking. P < 0.05 was considered significant. IBM SPSS Statistics (version 22; IBM Corp., Armonk, NY, USA) was used for all statistical analyses.