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首次和第六个月的肺功能测试随访能否了解 COVID-19 肺炎的长期呼吸系统影响?

Can 1st and 6th month pulmonary function test follow-ups give an idea about the long-term respiratory effects of COVID-19 pneumonia?

机构信息

University of Health Sciences Umraniye Training and Research Hospital, Department of Emergency Medicine - Istanbul, Turkey.

University of Health Sciences Umraniye Training and Research Hospital, Department of Pulmonary Medicine - Istanbul, Turkey.

出版信息

Rev Assoc Med Bras (1992). 2022 Feb;68(2):183-190. doi: 10.1590/1806-9282.20210890.

Abstract

OBJECTIVE

The aim of this study was to ascertain the long-term respiratory effects of COVID-19 pneumonia through pulmonary function tests in follow-ups at 1 and 6 months.

METHODS

Our study was conducted between August 1, 2020 and April 30, 2021. At 1 month after discharge, follow-up evaluations, PFTs, and lung imaging were performed on patients aged above 18 years who had been diagnosed with COVID-19 pneumonia. In the 6th month, the PFTs were repeated for those with pulmonary dysfunction.

RESULTS

A total of 219 patients (mean age, 49±11.9 years) were included. Pathological PFT results were noted in the 1st month for 80 patients and in the 6th month for 46 (7 had obstructive disorder, 15 had restrictive disorder, and 28 had small airway obstruction) patients. A significant difference was found between abnormal PFT results and patient-described dyspnea in the 1st month of follow-up. The 6-month PFT values (especially those for forced vital capacity) were statistically significantly lower in the patients for whom imaging did not indicate complete radiological improvement at the 1-month follow-up. No statistically significant difference was found between the severity of the first computed tomography findings or clinical condition on emergency admission and pulmonary dysfunction (Pearson's chi-square test, P=0.904; Fisher's exact test, P=0.727).

CONCLUSION

It is important that patients with COVID-19 pneumonia be followed up for at least 1 month after discharge to be monitored for potential long-term lung damage. PFTs should be administered to those in whom ongoing dyspnea, which started with COVID-19, and/or full recovery were not identified in pulmonary imaging.

摘要

目的

本研究旨在通过 1 个月和 6 个月的随访时的肺功能检查,确定 COVID-19 肺炎的长期呼吸影响。

方法

本研究于 2020 年 8 月 1 日至 2021 年 4 月 30 日进行。出院后 1 个月,对诊断为 COVID-19 肺炎的 18 岁以上患者进行随访评估、肺功能检查和肺部影像学检查。对于有肺功能障碍的患者,在第 6 个月重复进行肺功能检查。

结果

共纳入 219 例患者(平均年龄 49±11.9 岁)。第 1 个月有 80 例患者出现肺功能异常结果,第 6 个月有 46 例(7 例存在阻塞性障碍,15 例存在限制性障碍,28 例存在小气道阻塞)。在第 1 个月的随访中,异常肺功能检查结果与患者描述的呼吸困难之间存在显著差异。在第 1 个月随访时影像学未见完全影像学改善的患者,其 6 个月时的肺功能检查值(特别是用力肺活量)明显降低。首次 CT 检查结果严重程度或急诊入院时的临床状况与肺功能障碍之间无统计学差异(皮尔逊卡方检验,P=0.904;Fisher 确切概率检验,P=0.727)。

结论

对于 COVID-19 肺炎患者,出院后至少随访 1 个月以监测潜在的长期肺部损害非常重要。对于那些在肺部影像学检查中未发现持续呼吸困难(始于 COVID-19)和/或完全恢复的患者,应进行肺功能检查。

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