Qin Wei, Chen Shi, Zhang Yunxia, Dong Fen, Zhang Zhu, Hu Bingzhu, Zhu Ziyang, Li Fajiu, Wang Xiaojiang, Wang Yimin, Zhen Kaiyuan, Wang Jing, Wan YuLei, Li Hongbo, Elalamy Ismaïl, Li Chenghong, Zhai Zhenguo, Wang Chen
Dept of Pulmonary and Critical Care Medicine, Affiliated Hospital of Jianghan University, Wuhan, China.
These authors contributed equally as co-first authors.
Eur Respir J. 2021 Jul 22;58(1). doi: 10.1183/13993003.03677-2020. Print 2021 Jul.
To evaluate pulmonary function and clinical symptoms in coronavirus disease 2019 (COVID-19) survivors within 3 months after hospital discharge, and to identify risk factors associated with impaired lung function.
COVID-19 patients were prospectively followed-up with pulmonary function tests and clinical characteristics for 3 months following discharge from a hospital in Wuhan, China between January and February 2020.
647 patients were included. 87 (13%) patients presented with weakness, 63 (10%) with palpitations and 56 (9%) with dyspnoea. The prevalence of each of the three symptoms were markedly higher in severe patients than nonsevere patients (19% 10% for weakness, p=0.003; 14% 7% for palpitations, p=0.007; 12% 7% for dyspnoea, p=0.014). Results of multivariable regression showed increased odds of ongoing symptoms among severe patients (OR 1.7, 95% CI 1.1-2.6; p=0.026) or patients with longer hospital stays (OR 1.03, 95% CI 1.00-1.05; p=0.041). Pulmonary function test results were available for 81 patients, including 41 nonsevere and 40 severe patients. In this subgroup, 44 (54%) patients manifested abnormal diffusing capacity of the lung for carbon monoxide ( ) (68% severe 42% nonsevere patients, p=0.019). Chest computed tomography (CT) total severity score >10.5 (OR 10.4, 95% CI 2.5-44.1; p=0.001) on admission and acute respiratory distress syndrome (ARDS) (OR 4.6, 95% CI 1.4-15.5; p=0.014) were significantly associated with impaired . Pulmonary interstitial damage may be associated with abnormal .
Pulmonary function, particularly , declined in COVID-19 survivors. This decrease was associated with total severity score of chest CT >10.5 and ARDS occurrence. Pulmonary interstitial damage might contribute to the imparied .
评估2019冠状病毒病（COVID-19）幸存者出院后3个月内的肺功能及临床症状，并确定与肺功能受损相关的危险因素。
对2020年1月至2月间在中国武汉一家医院出院后的COVID-19患者进行前瞻性随访，为期3个月，记录其肺功能测试结果及临床特征。
共纳入647例患者。87例（13%）患者出现乏力，63例（10%）出现心悸，56例（9%）出现呼吸困难。这三种症状在重症患者中的发生率均显著高于非重症患者（乏力：19%对10%，p=0.003；心悸：14%对7%，p=0.007；呼吸困难：12%对7%，p=0.014）。多变量回归结果显示，重症患者（比值比[OR]1.7，95%置信区间[CI]1.1-2.6；p=0.026）或住院时间较长的患者（OR 1.03，95%CI 1.00-1.05；p=0.041）持续出现症状的几率增加。81例患者有肺功能测试结果，其中41例非重症患者和40例重症患者。在该亚组中，44例（54%）患者表现为一氧化碳肺弥散量（）异常（重症患者为68%，非重症患者为42%，p=0.019）。入院时胸部计算机断层扫描（CT）总严重程度评分>10.5（OR 10.4，95%CI 2.5-44.1；p=0.001）及急性呼吸窘迫综合征（ARDS）（OR 4.6，95%CI 1.4-15.5；p=0.014）与异常显著相关。肺间质损伤可能与异常有关。
COVID-19幸存者的肺功能，尤其是，出现下降。这种下降与胸部CT总严重程度评分>10.5及ARDS的发生有关。肺间质损伤可能导致受损。
