Department of Pulmonary Diseases, Ataturk University School of Medicine, Erzurum, Turkey.
Department of Pulmonary Diseases, Ağrı State Hospital, Ağrı, Turkey.
J Med Virol. 2022 May;94(5):2026-2034. doi: 10.1002/jmv.27579. Epub 2022 Jan 18.
In addition to the highly variable clinical presentation of acute COVID-19 infection, it can also cause various postacute signs and symptoms. This study aimed to evaluate patients with postacute COVID-19 over 12 weeks of follow-up. The study included 151 patients who were diagnosed with COVID-19 by real-time polymerase chain reaction of a nasopharyngeal swab 1 month earlier, had radiologic findings consistent with COVID-19 pneumonia, and presented to the post-COVID-19 outpatient clinic between May and August 2021. The patients were divided into three groups based on COVID-19 severity: nonsevere pneumonia (Group 1), severe pneumonia (Group 2), and severe pneumonia requiring intensive care (Group 3). Evaluation of laboratory parameters at 4 and 12 weeks showed that Group 3 had a higher lactose dehydrogenase (LDH) level and a lower mean platelet volume than the other groups at both time points (p = 0.001 for all). Group 3 also had lower percent predicted forced vital capacity (FVC%), percent predicted forced expiration volume in 1 s (FEV1%), and percent predicted diffusion capacity of the lungs for carbon monoxide divided by alveolar volume (DLCO/VA%) compared to Groups 1 and 2 at Week 4 (p = 0.001, 0.004, 0.001, respectively) and compared to Group 1 at 12 weeks (p = 0.002, 0.03, 0.001, respectively). Patients with persistent dyspnea at 12 weeks had significantly lower FEV1%, FVC%, DLCO/VA%, and saturation levels in room air and significantly higher LDH, pro-BNP, D-dimer, and heart rate compared to those without dyspnea (p = 0.001 for all). Although the lungs are most commonly affected after COVID-19 infection, vascular and endothelial damage also causes multisystem involvement. Our study indicates that laboratory values, radiological signs, and pulmonary functional capacity improved in most patients after 12 weeks of follow-up.
除了急性 COVID-19 感染高度可变的临床表现外,它还可能导致各种急性后期症状和体征。本研究旨在评估急性 COVID-19 感染后 12 周的患者。该研究纳入了 151 例患者,他们在 1 个月前通过实时聚合酶链反应检测鼻咽拭子诊断为 COVID-19,胸部 X 线检查有 COVID-19 肺炎的影像学表现,并在 2021 年 5 月至 8 月期间到 COVID-19 门诊就诊。根据 COVID-19 严重程度将患者分为三组:非重症肺炎(第 1 组)、重症肺炎(第 2 组)和需要重症监护的重症肺炎(第 3 组)。4 周和 12 周时的实验室参数评估显示,第 3 组在两个时间点的乳酸脱氢酶(LDH)水平均高于其他两组(p 值均 = 0.001),血小板平均体积均低于其他两组(p 值均 = 0.001)。与第 1 组和第 2 组相比,第 3 组在第 4 周时用力肺活量预计值百分比(FVC%)、1 秒用力呼气容积预计值百分比(FEV1%)和一氧化碳弥散量与肺泡容积比预计值百分比(DLCO/VA%)较低(p 值分别为 0.001、0.004 和 0.001),与第 1 组相比,第 3 组在第 12 周时 FEV1%、FVC%、DLCO/VA%和血氧饱和度较低(p 值分别为 0.002、0.03、0.001)。12 周时仍有持续性呼吸困难的患者的 FEV1%、FVC%、DLCO/VA%和血氧饱和度明显低于无呼吸困难的患者(p 值均 = 0.001),乳酸脱氢酶(LDH)、脑利钠肽前体(pro-BNP)、D-二聚体和心率明显高于无呼吸困难的患者(p 值均 = 0.001)。尽管 COVID-19 感染后肺部最常受累,但血管和内皮损伤也会导致多系统受累。我们的研究表明,大多数患者在 12 周的随访后,实验室值、影像学表现和肺功能均有所改善。