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COVID-19 住院 3 个月后的呼吸困难、肺功能和 CT 表现。

Dyspnoea, lung function and CT findings 3 months after hospital admission for COVID-19.

机构信息

Dept of Pulmonary Medicine, Oslo University Hospital Ullevål, Oslo, Norway.

Dept of Radiology and Nuclear Medicine, Oslo University Hospital Ullevål, Oslo, Norway.

出版信息

Eur Respir J. 2021 Apr 29;57(4). doi: 10.1183/13993003.03448-2020. Print 2021 Apr.

DOI:10.1183/13993003.03448-2020
PMID:33303540
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7736755/
Abstract

The long-term pulmonary outcomes of coronavirus disease 2019 (COVID-19) are unknown. We aimed to describe self-reported dyspnoea, quality of life, pulmonary function and chest computed tomography (CT) findings 3 months following hospital admission for COVID-19. We hypothesised outcomes to be inferior for patients admitted to intensive care units (ICUs), compared with non-ICU patients.Discharged COVID-19 patients from six Norwegian hospitals were enrolled consecutively in a prospective cohort study. The current report describes the first 103 participants, including 15 ICU patients. The modified Medical Research Council (mMRC) dyspnoea scale, the EuroQol Group's questionnaire, spirometry, diffusing capacity of the lung for carbon monoxide ( ), 6-min walk test, pulse oximetry and low-dose CT scan were performed 3 months after discharge.mMRC score was >0 in 54% and >1 in 19% of the participants. The median (25th-75th percentile) forced vital capacity and forced expiratory volume in 1 s were 94% (76-121%) and 92% (84-106%) of predicted, respectively. was below the lower limit of normal in 24% of participants. Ground-glass opacities (GGO) with >10% distribution in at least one of four pulmonary zones were present in 25% of participants, while 19% had parenchymal bands on chest CT. ICU survivors had similar dyspnoea scores and pulmonary function as non-ICU patients, but higher prevalence of GGO (adjusted OR 4.2, 95% CI 1.1-15.6) and lower performance in usual activities.3 months after admission for COVID-19, one-fourth of the participants had chest CT opacities and reduced diffusing capacity. Admission to ICU was associated with pathological CT findings. This was not reflected in increased dyspnoea or impaired lung function.

摘要

新型冠状病毒病 2019(COVID-19)的长期肺部后果尚不清楚。我们旨在描述 COVID-19 住院 3 个月后自我报告的呼吸困难、生活质量、肺功能和胸部计算机断层扫描(CT)结果。我们假设与非 ICU 患者相比,入住 ICU 的患者预后较差。

来自挪威六家医院的出院 COVID-19 患者连续入组前瞻性队列研究。本报告描述了前 103 名参与者,其中包括 15 名 ICU 患者。改良的医学研究委员会(mMRC)呼吸困难量表、欧洲五维健康量表问卷、肺活量测定、一氧化碳弥散量(DLCO)、6 分钟步行试验、脉搏血氧饱和度和低剂量 CT 扫描在出院后 3 个月进行。

在 54%的参与者中,mMRC 评分>0,在 19%的参与者中,mMRC 评分>1。用力肺活量和 1 秒用力呼气量的中位数(25 至 75 百分位数)分别为预测值的 94%(76-121%)和 92%(84-106%)。24%的参与者的 DLCO 低于正常值下限。至少有四个肺区中的一个区域的磨玻璃影(GGO)分布>10%的参与者占 25%,而 19%的参与者胸部 CT 有实质带。ICU 幸存者的呼吸困难评分和肺功能与非 ICU 患者相似,但 GGO 发生率更高(调整后的 OR 4.2,95%CI 1.1-15.6),日常活动能力较低。

COVID-19 住院 3 个月后,四分之一的参与者有胸部 CT 混浊和弥散能力降低。入住 ICU 与 CT 病理发现有关。但这并没有反映在呼吸困难加重或肺功能受损上。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5b8/7736755/7d7e9c7449d6/ERJ-03448-2020.01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5b8/7736755/7d7e9c7449d6/ERJ-03448-2020.01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5b8/7736755/7d7e9c7449d6/ERJ-03448-2020.01.jpg

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