新冠肺炎后肺功能和健康相关生活质量。

Pulmonary function and health-related quality of life after COVID-19 pneumonia.

机构信息

Amphia Hospital, Department of Pulmonary Medicine, Postbus 90158, 4800 RK Breda, the Netherlands.

出版信息

Respir Med. 2021 Jan;176:106272. doi: 10.1016/j.rmed.2020.106272. Epub 2020 Nov 30.

DOI:10.1016/j.rmed.2020.106272

PMID:33302142

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7701891/

Abstract

BACKGROUND

The COVID-19 pandemic has led to many cases of pneumonia with extensive lung abnormalities on CT-scans. The consequences of COVID-19 pneumonia on survivors' pulmonary function and quality of life are unknown. The purpose of this study is to examine the impact of COVID-19 pneumonia on pulmonary function, health-related quality of life (HRQoL) and perceived dyspnoea.

METHODS

A prospective longitudinal cohort study regarding patients discharged from our hospital after PCR-proven, non-critical COVID-19 pneumonia was conducted. Cases were classified as moderate or severe pneumonia according to WHO definitions. Six weeks post-discharge subjects underwent interviews and pulmonary function tests, and completed questionnaires to assess their HRQoL, perceived dyspnoea (Borgscale and mMRC), and symptoms of depression and anxiety (HADS).

RESULTS

101 patients were included. Twenty-eight (27.7%) pneumonias were classified as moderate cases of COVID-19 pneumonia and 73 (72.3%) were classified as severe cases. Diffusion limitation (DLCOc < 80% of predicted value) was found in 66 (71.7%) of 92 cases, obstruction in 26 (25.7%) of 101, and restriction in 21 (21.2%) of 99. Diffusion capacity was significantly lower in cases after severe pneumonia. In the entire group, HADS scores ≥8 for depression were found in 16.6% and in 12.5% for anxiety. Across all SF-36 domains, except for bodily pain, significant impairment was found. FEV1 and DLCOc showed significant positive correlations with mMRC scores and multiple SF-36 domains, especially physical functioning.

CONCLUSION

COVID-19 non-critical pneumonia survivors have significant impairment in diffusion capacity and HRQOL six weeks after being discharged from hospital.

摘要

背景

COVID-19 大流行导致许多患者出现 CT 扫描广泛肺部异常的肺炎。COVID-19 肺炎对幸存者肺功能和生活质量的影响尚不清楚。本研究的目的是研究 COVID-19 肺炎对肺功能、健康相关生活质量（HRQoL）和呼吸困难感知的影响。

方法

对我院经 PCR 证实的非危重新冠肺炎出院患者进行前瞻性纵向队列研究。根据世界卫生组织的定义，病例分为中度或重度肺炎。出院后 6 周，患者接受访谈和肺功能测试，并完成问卷调查，以评估他们的 HRQoL、呼吸困难感知（Borg 量表和 mMRC）以及抑郁和焦虑症状（HADS）。

结果

共纳入 101 例患者。28 例（27.7%）肺炎被归类为中度 COVID-19 肺炎，73 例（72.3%）被归类为重度肺炎。92 例中有 66 例（71.7%）存在弥散受限（DLCOc<预计值的 80%），101 例中有 26 例（25.7%）存在阻塞，99 例中有 21 例（21.2%）存在限制。重度肺炎后弥散能力显著降低。在整个组中，HADS 评分≥8 分的抑郁发生率为 16.6%，焦虑发生率为 12.5%。除了身体疼痛外，所有 SF-36 领域的评分都明显降低。FEV1 和 DLCOc 与 mMRC 评分和多个 SF-36 领域，尤其是身体功能呈显著正相关。