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                <identifier>oai:data.mendeley.com/92gvt9vmrm.3</identifier>
                <datestamp>2025-06-30T17:00:32Z</datestamp>
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            <metadata><oai_dc:dc xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
    <dc:creator id="https://orcid.org/0000-0002-4473-1601">Zavorsky, Gerald</dc:creator>
    <dc:title>The long term effects of COVID-19 on Pulmonary diffusing capacity for nitric oxide (DLNO) and carbon monoxide (DLCO) </dc:title>
    <dc:publisher>Mendeley Data</dc:publisher>
    <dc:description>Hypothesis: This study hypothesized that combining lung diffusing capacities for nitric oxide (DLNO) and carbon monoxide (DLCO) enhances detection of COVID-19-related lung pathologies over using DLCO alone, or spirometry, total lung capacity (TLC), or single measures. A combined DLNO+DLCO z-score was expected to better classify post-COVID lung function abnormalities, capturing a broader spectrum of pulmonary impairment.

Data Overview: The filtered pooled dataset (Covid19_Controls_Filtered.sav) includes 572 COVID-19 survivors &amp; 72 controls (644 total) who completed all pulmonary function tests (PFTs) across five countries: Italy, France, Spain, Denmark, and Australia. About 98% of data from these centers is published in 6 peer-reviewed journals &amp; 2 conference abstracts. Controls and COVID-19 cases were tested with the same equipment and protocols. The full PFT battery included DLNO and DLCO (median breath-hold 5.6 s), spirometry, and TLC, with z-scores from reference equations. COVID-19 survivors were tested 32–575 days post-infection (median 130 days). Missing TLC data was imputed. Mixed model binary logistic regression was used with “Study Site” as a random intercept, COVID-19 (1) vs. control (0) as the dependent variable, and z-scores for spirometry, TLC, and diffusion capacity as independent variables. Matthews correlation coefficient (MCC) assessed model classification using a threshold that maximized Youden&apos;s J.

Notable Findings: Among 572 post-COVID subjects aged 20–90 (median 60), 61 (11%) had confirmed restriction (TLC &lt; LLN, z-score &lt; -1.645). Additionally, 53% showed some type of impairment (obstruction, restriction, mixed disorder, or DLNO/DLCO &lt; LLN). Of 18 models evaluated, the one with the lowest Bayesian Information Criterion (BIC) was a combined DLNO+DLCO z-score model (DLNO and DLCO z-scores summed), showing superior COVID-19 detection. Four of the top five models were combined DLNO+DLCO or DLNO-only, while one was DLCO-only. MCC values showed all top five models were either combined or DLNO-only, with MCCs around 0.48. Dyspnea severity also correlated with combined, DLNO-only, and DLCO-only z-scores (p &lt; 0.001).

Data Interpretation and Implications: This study highlights that DLNO, when combined with DLCO, provides insights into COVID-19-altered lung diffusion, especially across the alveolar-capillary membrane. Combined z-scores improve post-COVID abnormality classification, supporting targeted follow-up for symptomatic survivors. Wider adoption of this approach would require regulatory approval and standardization. The combined technique shows promise in detecting subclinical COVID-19-related lung impairments, enhancing sensitivity in long-term monitoring.</dc:description>
    <dc:subject>Respiratory Medicine</dc:subject>
    <dc:subject>Pulmonary Function Test</dc:subject>
    <dc:subject>COVID-19 Diagnostics</dc:subject>
    <dc:contributor id="https://orcid.org/0000-0002-2349-5646">Barisioni, Giovanni </dc:contributor>
    <dc:contributor id="https://orcid.org/0000-0002-1577-6595">Gille, Thomas</dc:contributor>
    <dc:contributor id="https://orcid.org/0000-0001-6305-0732">Dal-Negro, Roberto</dc:contributor>
    <dc:contributor id="https://orcid.org/0000-0001-9088-3713">Nunez-Fernandez, Marta</dc:contributor>
    <dc:contributor id="https://orcid.org/0000-0001-8037-3824">Seccombe, Leigh</dc:contributor>
    <dc:contributor id="https://orcid.org/0000-0003-1139-6509">Imeri, Gianluca</dc:contributor>
    <dc:contributor id="https://orcid.org/0000-0002-1743-0504">Di Marco, Fabiano</dc:contributor>
    <dc:contributor id="https://orcid.org/0000-0002-1399-8995">Mortensen, Jann</dc:contributor>
    <dc:contributor id="https://orcid.org/0000-0002-8345-6382">Agostoni, Piergiuseppe</dc:contributor>
    <dc:contributor id="https://orcid.org/0000-0002-8448-7551">Salvioni, Elisabetta</dc:contributor>
    <dc:contributor id="https://orcid.org/0000-0001-8948-0896">Brusasco, Vito</dc:contributor>
    <dc:type>Dataset</dc:type>
    <dc:identifier>doi:10.17632/92gvt9vmrm.3</dc:identifier>
    <dc:identifier>oai:data.mendeley.com/92gvt9vmrm.3</dc:identifier>
    <dc:rights>Creative Commons Attribution 4.0 International</dc:rights>
    <dc:rights>http://creativecommons.org/licenses/by/4.0</dc:rights>
    <dc:relation>https://data.mendeley.com/datasets/92gvt9vmrm</dc:relation>
    <dc:date>2025-06-30T17:00:32Z</dc:date>
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