Spirometry
Spirometry has the possibility of causing aerosolization, so special consideration needs to be made (McGowan, A et al Recommendation from ERS Group 9.1 (Respiratory function technologists /Scientists-Lung function testing during COVID-19 pandemic and beyond).
The European Respiratory Society (ERS) does not recommend any patients with symptoms of COVID-19 or flu-like symptoms are tested with spirometry or Lung Function Tests (LFTs) under any circumstances at this time. They recommend postponing all routine testing during the pandemic phase. COVID-19 patients must not be tested for a minimum of 30 days post-infection.
Full operation of lung function services may only resume when viral prevalence is low and reliable testing based on a combination of symptom screening, and testing is readily available.
In the interim period, ERS is recommended only for critical need and if these mitigation strategies can be implemented
A test should always be carried out with a high specification disposable in-line bacterial and viral
filter in place with minimum proven efficiency for the high expiratory flow of 600 to 700 L/min.
The use of disposable combined mouthpieces/sensors is not recommended at this time. Maximize the use of single-use consumables and dispose of the items with care e.g., nose clips, rubber mouthpieces, etc.
For highest risk patients requiring essential testing, lung function should be carried out in a negative pressure room and using equipment only for high risk or infected patients.
This may only be available at specialist centers.
We recommend the use of either FFP3 masks or FFP2, where the former is not available. The
duration of the use of protective masks should comply with local policy. Eye protection must always be worn e.g., goggles or face shields.
Disposable gloves should be used at all times when testing. These should be discarded afterward.
Exercise testing, nebulization, bronchial challenge tests, and other aerosol-generating
procedures should be postponed during the pandemic until the green phase is reached.