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评估重症 COVID-19 幸存者的长期放射学发现、肺功能和健康相关生活质量。

Evaluation of long-term radiological findings, pulmonary functions, and health-related quality of life in survivors of severe COVID-19.

机构信息

Department of Chest Diseases, Sisli Hamidiye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.

Department of Infectious Diseases and Clinical Microbiology, Sisli Hamidiye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.

出版信息

J Med Virol. 2021 Sep;93(9):5574-5581. doi: 10.1002/jmv.27101. Epub 2021 May 31.

Abstract

OBJECTIVE

It was aimed to evaluate long-term radiological changes in severe coronavirus disease 2019 (COVID-19) patients, to investigate pulmonary function, exercise capacities, and health-related quality of life results.

METHODS

Sixty-five patients with severe COVID-19 pneumonia were evaluated in the sixth month after discharge from the hospital. Spirometry, 6 min walking test (6MWT), and short form of health-related quality of life scale (SF-36) were applied in the sixth month. Chest computed tomography (CT) was performed and the findings were grouped according to lung involvement.

RESULTS

Forty-nine male and 16 female patients were included in the study. Forced expiratory volume in 1 s (FEV1)% values of 18 patients (30.5%), forced vital capacity (FVC)% values of 27 patients (45.8%), and 6MWT of 13 patients (23.2%) were found lower than expected in the sixth month. On the SF-36 scale, physical function, energy-vitality, social functionality, pain, and general health parameters were found lower than normal. Minimal interstitial changes in chest CT were seen in 26 patients. Nine patients had lung area involvement between 10% and 50% of the surface, there was a correlation between FEV1% and FVC% values in this group. There was severe pulmonary fibrosis in four patients. There was a correlation between pulmonary function and physical function and general perception of health from SF-36 scale subparameters.

CONCLUSION

Functional and radiological abnormalities were detected in a significant number of patients in the sixth month after severe COVID-19 pneumonia. A systematic monitoring plan must be established to assess and properly manage the long-term problems that may arise.

摘要

目的

评估重症 2019 冠状病毒病(COVID-19)患者的长期放射学变化,研究肺功能、运动能力和健康相关生活质量结果。

方法

对 65 例出院后 6 个月的重症 COVID-19 肺炎患者进行评估。在第 6 个月进行肺量测定、6 分钟步行试验(6MWT)和健康相关生活质量量表(SF-36)的简短形式。进行胸部计算机断层扫描(CT)检查,并根据肺部受累情况对结果进行分组。

结果

本研究纳入 49 名男性和 16 名女性患者。18 例(30.5%)患者的 1 秒用力呼气量(FEV1)%值、27 例(45.8%)患者的用力肺活量(FVC)%值和 13 例(23.2%)患者的 6MWT 值低于预期。在 SF-36 量表上,身体功能、精力-活力、社会功能、疼痛和一般健康参数均低于正常值。26 例患者胸部 CT 显示轻微间质变化。9 例患者肺区受累面积占表面积的 10%至 50%,该组患者的 FEV1%和 FVC%值存在相关性。4 例患者存在严重肺纤维化。肺功能与身体功能和 SF-36 量表子参数的一般健康感知之间存在相关性。

结论

在重症 COVID-19 肺炎出院后 6 个月,大量患者存在功能和放射学异常。必须建立系统的监测计划,以评估和妥善管理可能出现的长期问题。

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