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新冠病毒感染患者出院6个月后的呼吸结局:一项前瞻性队列研究

Respiratory Outcomes After 6 Months of Hospital Discharge in Patients Affected by COVID-19: A Prospective Cohort.

作者信息

Prestes Gabriele da Silveira, Simon Carla Sasso, Walz Roger, Ritter Cristiane, Dal-Pizzol Felipe

机构信息

Laboratory of Translational Biomedicine, Graduate Program in Health Sciences, Universidade do Extremo Sul Catarinense, Criciuma, Brazil.

Laboratory of Experimental Pathophysiology, Graduate Program in Health Sciences, Universidade do Extremo Sul Catarinense, Criciúma, Brazil.

出版信息

Front Med (Lausanne). 2022 Mar 7;9:795074. doi: 10.3389/fmed.2022.795074. eCollection 2022.

Abstract

BACKGROUND

Considering millions of people affected by Coronavirus disease 2019 (COVID-19), long-lasting sequelae can significantly impact health worldwide. Data from prospective studies in lower-middle-income countries on persistent lung dysfunction secondary to COVID-19 are lacking. This work aims to determine risk factors and the impact of persistent lung dysfunctions in COVID-19 survivors.

METHODS

Observational and prospective cohort of patients admitted to a tertiary hospital from June 2020 to November 2020. Persistence of chest CT scan alterations, desaturation in the six-minute walk test (6MWT), forced expiratory volume in one second (FEV1), lung carbon monoxide diffusion (DLCO), and maximum inspiratory pressure (MIP) were measured 6 months after hospital discharge. Additionally, the Barthel index (BI) and the Modified Medical Research Council (mMRC) Dyspnea Scale were used to determine the impact of lung dysfunction in activities of daily living (ADL).

RESULTS

It was included 44 patients. Sixty percent had persistent lung CT scan abnormalities. From 18 to 43% of patients had at least one pulmonary function dysfunction, a decrease in FEV1 was the least prevalent (18%), and a reduction in DLCO and MIP was the most frequent (43%). In general, female gender, comorbidity index, and age were associated with worse lung function. Additionally, the presence of lung dysfunction could predict worse BI (r-square 0.28) and mMRC (r-square 0.32).

CONCLUSION

Long-term lung dysfunction is relatively common in survivors from severe COVID-19 and impacts negatively on ADL and the intensity of dyspnea, similar to studies in high-income countries.

摘要

背景

鉴于数百万的人受到2019冠状病毒病(COVID-19)的影响,长期后遗症会对全球健康产生重大影响。低收入和中等收入国家缺乏关于COVID-19继发的持续性肺功能障碍的前瞻性研究数据。这项研究旨在确定COVID-19幸存者持续性肺功能障碍的危险因素及其影响。

方法

对2020年6月至2020年11月入住一家三级医院的患者进行观察性前瞻性队列研究。在出院6个月后测量胸部CT扫描改变的持续性、六分钟步行试验(6MWT)中的血氧饱和度下降、一秒用力呼气量(FEV1)、肺一氧化碳弥散量(DLCO)和最大吸气压力(MIP)。此外,使用Barthel指数(BI)和改良医学研究委员会(mMRC)呼吸困难量表来确定肺功能障碍对日常生活活动(ADL)的影响。

结果

纳入了44例患者。60%的患者胸部CT扫描存在持续性异常。18%至43%的患者至少有一种肺功能障碍,FEV1降低最为少见(18%),而DLCO和MIP降低最为常见(43%)。总体而言,女性、合并症指数和年龄与较差的肺功能相关。此外,肺功能障碍的存在可预测较差的BI(决定系数为0.28)和mMRC(决定系数为0.32)。

结论

与高收入国家的研究类似,严重COVID-19幸存者中,长期肺功能障碍相对常见,并且对ADL和呼吸困难程度有负面影响。

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