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新冠后肺实质异常在随访三个月期间持续存在。

Persistence of post-COVID lung parenchymal abnormalities during the three-month follow-up.

机构信息

Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan.

Medical College, Aga Khan University, Karachi, Pakistan.

出版信息

Adv Respir Med. 2021;89(5):477-483. doi: 10.5603/ARM.a2021.0090. Epub 2021 Oct 6.

Abstract

INTRODUCTION

COVID-19-associated pulmonary sequalae have been increasingly reported after recovery from acute infection. Therefore, we aim to explore the charactersitics of persistent lung parenchymal abnormalities in patients with COVID-19.

MATERIAL AND METHODS

An observational study was conducted in patients with post-COVID lung parenchymal abnormalities from April till September 2020. Patients ≥18 years of age with COVID-19 who were diagnosed as post-COVID lung parenchymal abnormality based on respiratory symptoms and HRCT chest imaging after the recovery of acute infection. Data was recorded on a structured pro forma, and descriptive analysis was performed using Stata version 12.1.

RESULTS

A total of 30 patients with post-COVID lung parenchymal abnormalities were identified. The mean age of patients was 59.1 (SD 12.6), and 27 (90.0%) were males. Four HRCT patterns of lung parenchymal abnormalities were seen; organizing pneumonia in 10 (33.3%), nonspecific interstitial pneumonitis in 17 (56.7%), usual interstitial pneumonitis in 12 (40.0%) and probable usual interstitial pneumonitis in 14 (46.7%). Diffuse involvement was found in 15 (50.0%) patients, while peripheral predominance in 15 (50.0%), and other significant findings were seen in 8 (26.7%) patients. All individuals were treated with corticosteroids. The case fatality rate was 16.7%. Amongst the survivors, 32.0% recovered completely, 36.0% improved, while 32.0% of the patients had static or progressive disease.

CONCLUSION

This is the first study from Southeast Asia that identified post-COVID lung parenchymal abnormalities in patients who had no pre-existing lung disease highlighting the importance of timely recognition and treatment of this entity that might lead to fatal outcome.

摘要

简介

新冠肺炎(COVID-19)急性感染康复后,越来越多的患者出现与 COVID-19 相关的肺部后遗症。因此,我们旨在探索 COVID-19 患者持续性肺部实质异常的特征。

材料与方法

这是一项观察性研究,纳入了 2020 年 4 月至 9 月期间患有 COVID-19 肺部实质异常的患者。COVID-19 患者在急性感染康复后,因呼吸系统症状和 HRCT 胸部影像学而被诊断为 COVID-19 肺部实质异常。将数据记录在结构化表格中,并使用 Stata 版本 12.1 进行描述性分析。

结果

共发现 30 例 COVID-19 肺部实质异常患者。患者的平均年龄为 59.1(SD 12.6)岁,27 例(90.0%)为男性。发现 4 种肺部实质异常的 HRCT 模式:机化性肺炎 10 例(33.3%)、非特异性间质性肺炎 17 例(56.7%)、寻常型间质性肺炎 12 例(40.0%)和可能的寻常型间质性肺炎 14 例(46.7%)。15 例(50.0%)患者肺部弥漫性受累,15 例(50.0%)患者肺部外周性受累,8 例(26.7%)患者有其他显著发现。所有患者均接受了皮质类固醇治疗。病死率为 16.7%。在幸存者中,32.0%完全康复,36.0%改善,32.0%的患者肺部病变静止或进展。

结论

这是东南亚首例报道的无基础肺部疾病的 COVID-19 患者肺部实质异常病例,强调了及时识别和治疗这一实体的重要性,否则可能导致致命后果。

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