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重症新型冠状病毒肺炎患者出院后的肺功能评估

Pulmonary function evaluation after hospital discharge of patients with severe COVID-19.

作者信息

Polese Jessica, Sant'Ana Larissa, Moulaz Isac Ribeiro, Lara Izabella Cardoso, Bernardi Julia Muniz, Lima Marina Deorce de, Turini Elaína Aparecida Silva, Silveira Gabriel Carnieli, Duarte Silvana, Mill José Geraldo

机构信息

Departamento de Pneumologia, Universidade Federal do Espirito Santo, Vitoria, ES, BR.

Universidade Federal do Espirito Santo, Vitoria, ES, BR.

出版信息

Clinics (Sao Paulo). 2021 Jun 28;76:e2848. doi: 10.6061/clinics/2021/e2848. eCollection 2021.

Abstract

OBJECTIVES

Coronavirus disease 2019 (COVID-19) may be associated with prolonged symptoms and post-recovery health impairment. This study aimed to evaluate the persistence of symptoms, lung function, and pulmonary diffusion for carbon monoxide (DLCO) in patients between 15 and 30 days after hospital discharge after admission for severe COVID-19.

METHODS

The evaluation consisted of 1) comparative analysis between the initial symptoms and symptoms still present at the post-discharge evaluation 2) analysis of the chest images obtained during hospitalization, and 3) conducting spirometry, plethysmography, and DLCO assessment.

RESULTS

Forty-one patients who were hospitalized for 16±8 days with severe COVID-19 were included. Patients were predominantly men (73%) and had a mean age of 51±14 years. The most frequent comorbidities were arterial hypertension (51%) and diabetes mellitus (37%). Pulmonary evaluation was performed a mean of 36 days after the onset of symptoms, with the most frequent persistent symptoms being dyspnea (83%) and coughing (54%). Approximately 93% of patients still had at least one symptom, and 20% had more than five symptoms. Chest imaging revealed a typical pattern of COVID-19 on X-ray (93%) and computer tomography (95%). Lung function test results showed a restrictive pattern with a reduction in forced vital capacity (FVC) in 54% of individuals, with an average FVC of 78±14%. A reduction in DLCO was observed in 79% of patients.

CONCLUSIONS

We observed a high prevalence of symptoms, in addition to a significant change in lung function and DLCO, in the post-discharge assessment of patients requiring hospitalization after admission for COVID-19.

摘要

目的

2019冠状病毒病(COVID-19)可能与症状持续时间延长及康复后健康受损有关。本研究旨在评估重症COVID-19患者出院后15至30天内症状的持续情况、肺功能及一氧化碳弥散量(DLCO)。

方法

评估包括1)初始症状与出院后评估时仍存在的症状之间的对比分析;2)住院期间获得的胸部影像分析;3)进行肺量计检查、体积描记法检查及DLCO评估。

结果

纳入41例因重症COVID-19住院16±8天的患者。患者以男性为主(73%),平均年龄为51±14岁。最常见的合并症是动脉高血压(51%)和糖尿病(37%)。症状出现后平均36天进行肺部评估,最常见的持续症状是呼吸困难(83%)和咳嗽(54%)。约93%的患者仍至少有1种症状,20%的患者有超过5种症状。胸部影像学检查显示,X线(93%)和计算机断层扫描(95%)呈现典型的COVID-19影像特征。肺功能测试结果显示为限制性模式,54%的个体用力肺活量(FVC)降低,平均FVC为78±14%。79%的患者DLCO降低。

结论

我们观察到,在因COVID-19入院后需要住院治疗的患者出院后评估中,症状的患病率很高,此外肺功能和DLCO也有显著变化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c34c/8221559/cb2dd7bba354/cln-76-e2848-g001.jpg

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