Pulmonary function assessment after COVID-19 in vaccinated healthcare workers

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Abstract Long COVID refers to persistent symptoms following SARS-CoV-2 infection for at least 2 months with no other clear cause. Symptoms can occur after initial infection or during recovery and include chest pain, fatigue, breathlessness and cough. The exact causes are being investigated and may involve organ damage, inflammation or an immune response. COVID-19 can cause severe respiratory damage and is different from classic ARDS. Radiological assessment is recommended for those with dyspnoea after COVID. Clinical outcomes are variable and permanent lung damage is not fully understood. Vaccination is effective against severe infection, but its effect on respiratory function in mild cases remains uncertain. This retrospective study aims to analyse changes in lung function in HCWs who had COVID-19 between 2020 and 2022, comparing their spirometric test results before and after the pandemic and taking into account their vaccination status. 321 HCWs were included in the study. The study examined spirometric parameters both before and after the pandemic, and all measured outcomes except the FEV1/FVC ratio showed a significant decrease during the study period. We then assessed the association between COVID-19 infection and changes in lung function parameters, analysing infections in 2020, 2021 and 2022 separately. We found a statistically significant difference in Forced vital capacity (FVC) between infected and non-infected subjects in 2020 and 2021, but not in 2022. To evaluate the protective effect of SARS-CoV-2 vaccination on respiratory function, a linear regression analysis was performed using changes in FVC, Forced expiratory volume in 1 second (FEV1), FVC/FEV1 ratio and Peak expiratory flow (PEF) as dependent variables. The analysis showed that the decline in FVC was significantly lower in subjects who had been vaccinated prior to infection. The study concludes that subclinical COVID-19 infections in 2020 and 2021 worsened respiratory parameters (FVC and FEV1), but vaccination protected against these effects. Even healthy individuals with previous infections showed respiratory changes, with vaccination providing protection, especially for FVC decline. This highlights the importance of vaccinating healthcare workers against COVID-19.

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