Guangzhou Eighth People's Hospital, Guangdong, China.
Tsinghua-Berkeley Shenzhen Institute, Tsinghua University, Shenzhen, China.
J Xray Sci Technol. 2021;29(5):741-762. doi: 10.3233/XST-210920.
Monitoring recovery process of coronavirus disease 2019 (COVID-19) patients released from hospital is crucial for exploring residual effects of COVID-19 and beneficial for clinical care. In this study, a comprehensive analysis was carried out to clarify residual effects of COVID-19 on hospital discharged patients.
Two hundred sixty-eight cases with laboratory measured data at hospital discharge record and five follow-up visits were retrospectively collected to carry out statistical data analysis comprehensively, which includes multiple statistical methods (e.g., chi-square, T-test and regression) used in this study.
Study found that 13 of 21 hematologic parameters in laboratory measured dataset and volume ratio of right lung lesions on CT images highly associated with COVID-19. Moderate patients had statistically significant lower neutrophils than mild and severe patients after hospital discharge, which is probably caused by more efforts on severe patients and slightly neglection of moderate patients. COVID-19 has residual effects on neutrophil-to-lymphocyte ratio (NLR) of patients who have hypertension or chronic obstructive pulmonary disease (COPD). After released from hospital, female showed better performance in T lymphocytes subset cells, especially T helper lymphocyte% (16% higher than male). According to this sex-based differentiation of COVID-19, male should be recommended to take clinical test more frequently to monitor recovery of immune system. Patients over 60 years old showed unstable recovery process of immune cells (e.g., CD45 + lymphocyte) within 75 days after discharge requiring longer clinical care. Additionally, right lung was vulnerable to COVID-19 and required more time to recover than left lung.
Criterion of hospital discharge and strategy of clinical care should be flexible in different cases due to residual effects of COVID-19, which depend on several impact factors. Revealing remaining effects of COVID-19 is an effective way to eliminate disorder of mental health caused by COVID-19 infection.
监测从医院出院的 2019 冠状病毒病（COVID-19）患者的康复过程对于探索 COVID-19 的残留影响以及临床护理非常重要。在本研究中，对 COVID-19 对出院患者的残留影响进行了综合分析。
回顾性收集了 268 例有实验室检测数据的出院患者和 5 次随访的病例，对其进行综合统计数据分析，包括本研究中使用的多种统计方法（如卡方检验、T 检验和回归）。
研究发现，实验室检测数据集的 21 项血液学参数中的 13 项和 CT 图像上右肺病变的体积比与 COVID-19 高度相关。中度患者出院后中性粒细胞明显低于轻度和重度患者，这可能是因为对重度患者的治疗更为重视，而对中度患者的关注略少。COVID-19 对患有高血压或慢性阻塞性肺疾病（COPD）的患者的中性粒细胞与淋巴细胞比值（NLR）有残留影响。出院后，女性在 T 淋巴细胞亚群细胞方面表现出更好的性能，尤其是 T 辅助淋巴细胞%（比男性高 16%）。根据 COVID-19 的这种基于性别的差异，建议男性更频繁地进行临床检查，以监测免疫系统的恢复情况。60 岁以上的患者在出院后 75 天内免疫细胞（如 CD45+淋巴细胞）的恢复过程不稳定，需要更长时间的临床护理。此外，右肺比左肺更容易受到 COVID-19 的影响，需要更长的时间才能恢复。
由于 COVID-19 的残留影响，不同情况下的出院标准和临床护理策略应具有灵活性，这取决于几个影响因素。揭示 COVID-19 的剩余影响是消除 COVID-19 感染引起的心理健康紊乱的有效方法。
