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接受持续气道正压通气治疗的 COVID-19 急性呼吸衰竭患者的 6 个月呼吸结局和运动能力。

Six-month respiratory outcomes and exercise capacity of COVID-19 acute respiratory failure patients treated with continuous positive airway pressure.

机构信息

Unit of General Medicine and Advanced Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.

Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.

出版信息

Intern Med J. 2021 Nov;51(11):1810-1815. doi: 10.1111/imj.15345.

DOI:10.1111/imj.15345
PMID:33961728
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8242499/
Abstract

BACKGROUND

COVID-19 long-term sequelae are ill-defined since only a few studies have explored the long-term consequences of this disease so far.

AIMS

To evaluate the 6-month respiratory outcome and exercise capacity of COVID-19 acute respiratory failure (ARF) patients treated with continuous positive airway pressure (CPAP) during the first wave of the ongoing COVID-19 pandemic.

METHODS

A retrospective observational study included COVID-19 patients with ARF. Interventions included CPAP during hospitalisation and 6-month follow up. Frailty assessment was carried out through frailty index (FI), pO /FiO during hospitalisation and at follow up, respiratory parameters, 6-min walking test (6MWT) and the modified British Medical Research Council (mMRC) and Borg scale at follow up.

RESULTS

More than half of the patients had no dyspnoea according to the mMRC scale. Lower in-hospital pO /FiO correlated with higher Borg scale levels after 6MWT (ρ 0.27; P 0.04) at the follow-up visit. FI was positively correlated with length of hospitalisation (ρ 0.3; P 0.03) and negatively with the 6MWT distance walked (ρ -0.36; P 0.004).

CONCLUSIONS

Robust and frail patients with COVID-19 ARF treated with CPAP outside the intensive care unit setting had good respiratory parameters and exercise capacity at 6-month follow up, although more severe patients had slightly poorer respiratory performance compared with patients with higher PaO /FiO and lower FI.

摘要

背景

由于迄今为止只有少数研究探讨了这种疾病的长期后果,因此 COVID-19 的长期后遗症仍不明确。

目的

评估在当前 COVID-19 大流行的第一波期间,接受持续气道正压通气(CPAP)治疗的 COVID-19 急性呼吸衰竭(ARF)患者的 6 个月呼吸结局和运动能力。

方法

一项回顾性观察性研究纳入了 COVID-19 合并 ARF 的患者。干预措施包括住院期间和 6 个月随访期间的 CPAP。通过虚弱指数(FI)、住院期间和随访时的 pO /FiO 来进行虚弱评估,同时在随访时评估呼吸参数、6 分钟步行测试(6MWT)以及改良英国医学研究委员会(mMRC)和 Borg 量表。

结果

根据 mMRC 量表,超过一半的患者没有呼吸困难。住院期间较低的 pO /FiO 与随访时 6MWT 后较高的 Borg 量表评分相关(ρ 0.27;P 0.04)。FI 与住院时间呈正相关(ρ 0.3;P 0.03),与 6MWT 行走距离呈负相关(ρ -0.36;P 0.004)。

结论

在重症监护病房外接受 CPAP 治疗的 COVID-19 ARF 患者中,无论是健壮型还是虚弱型患者,在 6 个月随访时的呼吸参数和运动能力均良好,尽管与 PaO /FiO 较高和 FI 较低的患者相比,病情较重的患者的呼吸功能稍差。

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