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新冠长期后遗症的肺部表现及管理考量

Long COVID-19 Pulmonary Sequelae and Management Considerations.

作者信息

Boutou Afroditi K, Asimakos Andreas, Kortianou Eleni, Vogiatzis Ioannis, Tzouvelekis Argyris

机构信息

Department of Respiratory Medicine, "G. Papanikolaou" Hospital, 57010 Thessaloniki, Greece.

Critical Care Department and Pulmonary Unit, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, 10676 Athens, Greece.

出版信息

J Pers Med. 2021 Aug 26;11(9):838. doi: 10.3390/jpm11090838.

Abstract

The human coronavirus 2019 disease (COVID-19) and the associated acute respiratory distress syndrome (ARDS) are responsible for the worst global health crisis of the last century. Similarly, to previous coronaviruses leading to past pandemics, including severe acute respiratory syndrome (SARS) and middle east respiratory syndrome (MERS), a growing body of evidence support that a substantial minority of patients surviving the acute phase of the disease present with long-term sequelae lasting for up to 6 months following acute infection. The clinical spectrum of these manifestations is widespread across multiple organs and consists of the long-COVID-19 syndrome. The aim of the current review is to summarize the current state of knowledge on the pulmonary manifestations of the long COVID-19 syndrome including clinical symptoms, parenchymal, and functional abnormalities, as well as highlight epidemiology, risk factors, and follow-up strategies for early identification and timely therapeutic interventions. The literature data on management considerations including the role of corticosteroids and antifibrotic treatment, as well as the therapeutic potential of a structured and personalized pulmonary rehabilitation program are detailed and discussed.

摘要

2019年人类冠状病毒病(COVID-19)及相关急性呼吸窘迫综合征(ARDS)是上世纪最严重的全球健康危机的罪魁祸首。同样,与导致过去大流行的既往冠状病毒(包括严重急性呼吸综合征(SARS)和中东呼吸综合征(MERS))一样,越来越多的证据支持,相当一部分在疾病急性期存活下来的患者会出现急性感染后长达6个月的长期后遗症。这些表现的临床范围广泛累及多个器官,构成了长程COVID-19综合征。本综述的目的是总结关于长程COVID-19综合征肺部表现的当前知识状态,包括临床症状、实质和功能异常,以及强调流行病学、危险因素和早期识别及及时治疗干预的随访策略。详细阐述并讨论了关于管理考量的文献数据,包括皮质类固醇和抗纤维化治疗的作用,以及结构化和个性化肺康复计划的治疗潜力。

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