Department of Respiratory and Critical Care MedicineTongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Key Laboratory of Respiratory Diseases, National Ministry of Health of the People's Republic of China and National Clinical Research Center for Respiratory Disease, Wuhan, China.
Sci Rep. 2021 Jul 5;11(1):13854. doi: 10.1038/s41598-021-93191-y.
To describe the long-term health outcomes of patients with COVID-19 and investigate the potential risk factors. Clinical data during hospitalization and at a mean (SD) day of 249 (15) days after discharge from 40 survivors with confirmed COVID-19 (including 25 severe cases) were collected and analyzed retrospectively. At follow-up, severe cases had higher incidences of persistent symptoms, DLCO impairment, and higher abnormal CT score as compared with mild cases. CT score at follow-up was positively correlated with age, LDH level, cumulative days of oxygen treatment, total dosage of glucocorticoids used, and CT peak score during hospitalization. DLCO% at follow-up was negatively correlated with cumulative days of oxygen treatment during hospitalization. DLCO/VA% at follow-up was positively correlated with BMI, and TNF-α level. Among the three groups categorized as survivors with normal DLCO, abnormal DLCO but normal DLCO/VA, and abnormal DLCO and DLCO/VA, survivors with abnormal DLCO and DLCO/VA had the lowest serum IL-2R, IL-8, and TNF-α level, while the survivors with abnormal DLCO but normal DLCO/VA had the highest levels of inflammatory cytokines during hospitalization. Altogether, COVID-19 had a greater long-term impact on the lung physiology of severe cases. The long-term radiological abnormality maybe relate to old age and the severity of COVID-19. Either absent or excess of inflammation during COVID-19 course would lead to the impairment of pulmonary diffusion function.
描述 COVID-19 患者的长期健康结果，并探讨潜在的危险因素。回顾性收集并分析了 40 名确诊 COVID-19（包括 25 例重症）幸存者在住院期间和出院后 249（15）天的平均（SD）日的临床数据。在随访中，与轻症病例相比，重症病例持续性症状、DLCO 损害和更高的异常 CT 评分的发生率更高。随访时的 CT 评分与年龄、LDH 水平、累计吸氧天数、使用的糖皮质激素总量和住院期间的 CT 峰值评分呈正相关。随访时的 DLCO%与住院期间的累计吸氧天数呈负相关。随访时的 DLCO/VA%与 BMI 和 TNF-α水平呈正相关。在分为 DLCO 正常、DLCO 异常但 DLCO/VA 正常和 DLCO 异常且 DLCO/VA 异常的三组幸存者中，DLCO 异常且 DLCO/VA 异常的幸存者的血清 IL-2R、IL-8 和 TNF-α水平最低，而 DLCO 异常但 DLCO/VA 正常的幸存者在住院期间的炎症细胞因子水平最高。总的来说，COVID-19 对重症患者的肺生理功能有更大的长期影响。长期影像学异常可能与年龄和 COVID-19 的严重程度有关。在 COVID-19 病程中，无论是炎症不足还是过度，都会导致肺弥散功能受损。
