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COVID-19 对肺功能、功能能力和生活质量的中期影响。

Medium-term impact of COVID-19 on pulmonary function, functional capacity and quality of life.

机构信息

ASST Valtellina and Alto Lario, Eugenio Morelli Hospital, Sondalo, Italy

ASST Valtellina and Alto Lario, Eugenio Morelli Hospital, Sondalo, Italy.

出版信息

Eur Respir J. 2021 Sep 16;58(3). doi: 10.1183/13993003.04015-2020. Print 2021 Sep.

Abstract

BACKGROUND

Coronavirus disease 2019 (COVID-19) has spread worldwide, having a dramatic impact on healthcare systems. The aim of this study is to evaluate mid-term clinical impact of COVID-19 on respiratory function.

METHODS

379 patients were evaluated 4 months after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diagnosis. Patients were divided in two groups based on the presence of pneumonia during COVID-19. Clinical conditions, quality of life, symptomatology, 6-min walk test, pulmonary function test with spirometry and diffusing capacity of the lung for carbon monoxide were analysed. Data were compared to clinical evolution during COVID-19 (development of acute respiratory distress syndrome, need of invasive mechanical ventilation, partial oxygen saturation ( )/inspiratory oxygen fraction ( ) ratio and pneumonia severity index (PSI)).

RESULTS

After a median 135 days, 260 (68.6%) out of 379 patients referred at least one symptom. Patients who developed pneumonia during COVID-19 showed lower at rest (p<0.001), during 6-min walk test (p<0.001), total lung capacity (p<0.001), airway occlusion pressure after 0.1 s ( ) (p=0.02), /maximal inspiratory pressure ratio (p=0.005) and higher Borg category-ratio scale (p=0.006) and modified Medical Research Council breathlessness scale (p=0.003), compared to patients without pneumonia. / ratio and PSI during SARS-CoV-2 pneumonia were directly associated with mid-term alteration of at rest (p<0.001) and during 6-min walk test (p<0.001), residual volume (p<0.001), total lung capacity (p<0.001 and p=0.003, respectively) and forced vital capacity (p=0.004 and p=0.03, respectively).

CONCLUSION

Lung damage during COVID-19 correlates to the reduction of pulmonary function 4 months after acute infection.

摘要

背景

2019 年冠状病毒病(COVID-19)已在全球范围内传播,对医疗保健系统产生了巨大影响。本研究旨在评估 COVID-19 对呼吸功能的中期临床影响。

方法

对 379 例严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)诊断后 4 个月的患者进行评估。根据 COVID-19 期间是否存在肺炎,将患者分为两组。分析临床情况、生活质量、症状、6 分钟步行试验、肺功能测定(肺活量计和一氧化碳弥散量)。将数据与 COVID-19 期间的临床演变(急性呼吸窘迫综合征的发展、需要有创机械通气、血氧饱和度(SpO2)/吸氧分数(FiO2)比值和肺炎严重指数(PSI))进行比较。

结果

379 例患者中有 260 例(68.6%)至少出现一种症状,中位数随访时间为 135 天。COVID-19 期间发生肺炎的患者,在休息时 SpO2 更低(p<0.001)、6 分钟步行试验时 SpO2 更低(p<0.001)、总肺活量(p<0.001)、0.1s 后气道闭塞压( )(p=0.02)、/最大吸气压力比(p=0.005)更高,Borg 分级比量表(p=0.006)和改良的英国医学研究理事会呼吸困难量表(p=0.003)更高。SARS-CoV-2 肺炎时的 SpO2/FiO2 比值和 PSI 与中期休息时 SpO2 改变(p<0.001)和 6 分钟步行试验时 SpO2 改变(p<0.001)、残气量(p<0.001)、总肺活量(p<0.001 和 p=0.003)和用力肺活量(p=0.004 和 p=0.03)直接相关。

结论

COVID-19 期间的肺部损伤与急性感染后 4 个月的肺功能下降相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce6d/7877327/12131beb477d/ERJ-04015-2020.01.jpg

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