Southport and Ormskirk NHS Trust, Southport, PR8 6PN, UK.
BMC Infect Dis. 2021 Dec 8;21(1):1233. doi: 10.1186/s12879-021-06941-8.
The British Thoracic Society (BTS) recommends that all patients admitted with COVID-19 pneumonia should have a chest X-ray (CXR) and clinical follow-up at 6 or 12 weeks, depending on the disease severity. Little data is available on long-term CXR follow-up for moderate and severe COVID-19 pneumonia. This study aims to evaluate compliance with clinico-radiological follow-up of patients recovering from COVID-19 pneumonia at a local hospital in the UK, as per the BTS guidance, and to analyse radiological changes at clinical follow-up at 12 weeks, in order to risk-stratify and improve patient outcomes.
This is a single-centre retrospective audit of 255 consecutive COVID-19 positive patients admitted to a local hospital in the UK over 5 months between May and October 2020. All CXRs and clinic follow-up at 12 ± 8 weeks were checked on an electronic database.
Over one in two (131/255) patients had CXR evidence of COVID-19 pneumonia during the initial hospital admission. Half of the patients (60/131) died before CXR or clinic follow-up. Fifty-eight percent (41/71) of the surviving patients had a follow-up CXR, and only two developed respiratory complications- one had residual lung fibrosis, another a pulmonary embolism. Eighty-eight percent (36/41) of the patients had either resolution or improved radiological changes at follow-up. Most patients who had abnormal follow-up CXR were symptomatic (6/8), and many asymptomatic patients at follow-up had a normal CXR (10/12).
Although there were concerns about interstitial lung disease (ILD) incidence in patients with COVID-19 pneumonia, most of our patients with COVID-19 pneumonia had no pulmonary complications at follow-up with CXR. This emphasises that CXR, a cost-effective investigation, can be used to risk-stratify patients for long term pulmonary complications following their COVID-19 pneumonia. However, we acknowledge the limitations of a low CXR and clinic follow-up rate in our cohort.
英国胸科学会（BTS）建议，所有因 COVID-19 肺炎住院的患者应根据疾病严重程度，在 6 或 12 周时进行胸部 X 光（CXR）和临床随访。关于中度和重度 COVID-19 肺炎患者的长期 CXR 随访，数据很少。本研究旨在评估根据 BTS 指南，在英国当地医院对 COVID-19 肺炎康复患者进行临床放射学随访的依从性，并分析 12 周临床随访时的放射学变化，以便进行风险分层并改善患者预后。
这是对 2020 年 5 月至 10 月期间英国当地一家医院收治的 255 例连续 COVID-19 阳性患者的单中心回顾性审计。在电子数据库中检查所有 CXR 和 12 ± 8 周的临床随访。
超过一半（131/255）的患者在初次住院期间有 COVID-19 肺炎的 CXR 证据。一半（60/131）的患者在 CXR 或临床随访前死亡。71 例存活患者中有 60 例（41/71）进行了随访 CXR，仅 2 例发生呼吸并发症-1 例有残余肺纤维化，另 1 例有肺栓塞。88%（36/41）的患者在随访时出现了影像学改善或恢复。大多数有异常随访 CXR 的患者有症状（6/8），而许多无症状患者在随访时 CXR 正常（10/12）。
尽管人们对 COVID-19 肺炎患者间质性肺病（ILD）发生率存在担忧，但我们大多数 COVID-19 肺炎患者在随访时没有 CXR 肺部并发症。这强调了 CXR 是一种具有成本效益的检查，可以用于对 COVID-19 肺炎患者的长期肺部并发症进行风险分层。然而，我们承认我们的队列中 CXR 和临床随访率低的局限性。
