{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T18:58:26Z","timestamp":1791485906680,"version":"4.3.4"},"reference-count":20,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,4,5]],"date-time":"2023-04-05T00:00:00Z","timestamp":1680652800000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Physiological Reports"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Reduced carbon monoxide diffusing capacity (DL<jats:sub>CO<\/jats:sub>) is common after recovery from severe COVID\u201019 pneumonitis. The extent to which this relates to alveolar membrane dysfunction as opposed to vascular injury is uncertain. Simultaneous measurement of nitric oxide diffusing capacity (DL<jats:sub>NO<\/jats:sub>) and DL<jats:sub>CO<\/jats:sub> can partition gas diffusion into its two components: alveolar\u2013capillary membrane conductance (D<jats:sub>mCO<\/jats:sub>) and capillary blood volume (V<jats:sub>C<\/jats:sub>). We sought to evaluate D<jats:sub>mCO<\/jats:sub> and V<jats:sub>C<\/jats:sub> in the early and later recovery periods after severe COVID\u201019. Patients attended for post\u2010COVID\u201019 clinical review and lung function testing including DL<jats:sub>NO<\/jats:sub>\/DL<jats:sub>CO<\/jats:sub>. Repeat testing occurred when indicated and comparisons made using <jats:italic>t<\/jats:italic>\u2010tests. Forty\u2010nine (eight female) subjects (mean\u2009\u00b1\u2009SD age: 58\u2009\u00b1\u200913, BMI: 34\u2009\u00b1\u20098) who had severe COVID\u201019 pneumonitis, WHO severity classification of 6\u2009\u00b1\u20091, and prolonged (21\u2009\u00b1\u200922\u2009days) hospital stay, were assessed 2\u2009months (61\u2009\u00b1\u200935\u2009days) post discharge. DL<jats:sub>CO<\/jats:sub>adj (<jats:italic>z<\/jats:italic>\u2010score \u22121.70\u2009\u00b1\u20091.49, 25\/49\u2009&lt;\u2009lower limit of normal [LLN]) and total lung capacity (<jats:italic>z<\/jats:italic>\u2010score \u22121.71\u2009\u00b1\u20091.30) were both reduced. D<jats:sub>mCO<\/jats:sub> and V<jats:sub>C<\/jats:sub> and were reduced to a similar extent (<jats:italic>z<\/jats:italic>\u2010score \u22121.19\u2009\u00b1\u20091.05 and \u22121.41\u2009\u00b1\u20091.20, <jats:italic>p<\/jats:italic>\u2009=\u20090.4). Seventeen (one female) patients returned for repeat testing 4\u2009months (122\u2009\u00b1\u200961\u2009days) post discharge. In this subgroup with more impaired lung function, DL<jats:sub>CO<\/jats:sub>adj improved but remained below LLN (<jats:italic>z<\/jats:italic>\u2010score \u22123.15\u2009\u00b1\u20090.83 vs. \u22122.39\u2009\u00b1\u20090.86, <jats:italic>p<\/jats:italic>\u2009=\u20090.01), 5\/17 improved to &gt;LNN. D<jats:sub>mCO<\/jats:sub> improved (<jats:italic>z<\/jats:italic>\u2010score \u22122.05\u2009\u00b1\u20090.89 vs. \u22121.41\u2009\u00b1\u20090.78, <jats:italic>p<\/jats:italic>\u2009=\u20090.01) but V<jats:sub>C<\/jats:sub> was unchanged (<jats:italic>z<\/jats:italic>\u2010score \u22122.51\u2009\u00b1\u20090.55 vs. \u22122.29\u2009\u00b1\u20090.59, <jats:italic>p<\/jats:italic>\u2009=\u20090.16). Alveolar membrane conductance is abnormal in the earlier recovery phase following severe COVID\u201019 but significantly improves. In contrast, reduced V<jats:sub>C<\/jats:sub> persists. These data raise the possibility that persisting effects of acute vascular injury may contribute to gas diffusion impairment long after severe COVID\u201019 pneumonitis.<\/jats:p>","DOI":"10.14814\/phy2.15660","type":"journal-article","created":{"date-parts":[[2023,4,6]],"date-time":"2023-04-06T05:20:30Z","timestamp":1680758430000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Mechanisms of gas transfer impairment utilizing nitric oxide following severe <scp>COVID<\/scp>\u201019 pneumonitis"],"prefix":"10.14814","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8037-3824","authenticated-orcid":false,"given":"Leigh M.","family":"Seccombe","sequence":"first","affiliation":[{"name":"Thoracic Medicine, Concord Hospital  Concord New South Wales Australia"},{"name":"Faculty of Medicine and Health The University of Sydney  Camperdown New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Heath","sequence":"additional","affiliation":[{"name":"Thoracic Medicine, Concord Hospital  Concord New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claude S.","family":"Farah","sequence":"additional","affiliation":[{"name":"Thoracic Medicine, Concord Hospital  Concord New South Wales Australia"},{"name":"Faculty of Medicine and Health The University of Sydney  Camperdown New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James R.","family":"Di\u00a0Michiel","sequence":"additional","affiliation":[{"name":"Thoracic Medicine, Concord Hospital  Concord New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth M.","family":"Veitch","sequence":"additional","affiliation":[{"name":"Thoracic Medicine, Concord Hospital  Concord New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Peters","sequence":"additional","affiliation":[{"name":"Thoracic Medicine, Concord Hospital  Concord New South Wales Australia"},{"name":"Faculty of Medicine and Health The University of Sydney  Camperdown New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,4,5]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00964.2015"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.14814\/phy2.14748"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00458.2022"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00016-2016"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201908-1590ST"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0034-5687(87)80036-1"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resp.2016.03.003"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00289-2020"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2020-216797"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resmer.2021.100822"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10102119"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1183\/23120541.00224-2022"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00080312"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1183\/23120541.00193-2021"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-022-07511-7"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00010-2017"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cophys.2021.03.005"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pulmoe.2020.10.013"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.05.00035005"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00962-2016"}],"container-title":["Physiological 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