COVID-19 肺炎 1 年后的肺损伤胸部 CT：CovILD 研究。
Chest CT of Lung Injury 1 Year after COVID-19 Pneumonia: The CovILD Study.
机构信息
From the Departments of Radiology (A.K.L., L.G., C.S., A.K.G., G.M.F., G.W.), Internal Medicine (T.S., K.C., P.T., A.P., S.S., A.B., M.C., G.W., R.K., I.T., J.L.R.), and Visceral, Transplant and Thoracic Surgery (C.J.S.), Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; Department of Internal Medicine, St Vinzenz Hospital, Zams, Austria (E.W.); and Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna General Hospital, Vienna, Austria (H.P.).
出版信息
Radiology. 2022 Aug;304(2):462-470. doi: 10.1148/radiol.211670. Epub 2022 Mar 29.
Background The long-term pulmonary sequelae of COVID-19 is not well known. Purpose To characterize patterns and rates of improvement of chest CT abnormalities 1 year after COVID-19 pneumonia. Materials and Methods This was a secondary analysis of a prospective, multicenter observational cohort study conducted from April 29 to August 12, 2020, to assess pulmonary abnormalities at chest CT approximately 2, 3, and 6 months and 1 year after onset of COVID-19 symptoms. Pulmonary findings were graded for each lung lobe using a qualitative CT severity score (CTSS) ranging from 0 (normal) to 25 (all lobes involved). The association of demographic and clinical factors with CT abnormalities after 1 year was assessed with logistic regression. The rate of change of the CTSS at follow-up CT was investigated by using the Friedmann test. Results Of 142 enrolled participants, 91 underwent a 1-year follow-up CT examination and were included in the analysis (mean age, 59 years ± 13 [SD]; 35 women [38%]). In 49 of 91 (54%) participants, CT abnormalities were observed: 31 of 91 (34%) participants showed subtle subpleural reticulation, ground-glass opacities, or both, and 18 of 91 (20%) participants had extensive ground-glass opacities, reticulations, bronchial dilation, microcystic changes, or a combination thereof. At multivariable analysis, age of more than 60 years (odds ratio [OR], 5.8; 95% CI: 1.7, 24; = .009), critical COVID-19 severity (OR, 29; 95% CI: 4.8, 280; < .001), and male sex (OR, 8.9; 95% CI: 2.6, 36; < .001) were associated with persistent CT abnormalities at 1-year follow-up. Reduction of CTSS was observed in participants at subsequent follow-up CT ( < .001); during the study period, 49% (69 of 142) of participants had complete resolution of CT abnormalities. Thirty-one of 49 (63%) participants with CT abnormalities showed no further improvement after 6 months. Conclusion Long-term CT abnormalities were common 1 year after COVID-19 pneumonia. © RSNA, 2022 See also the editorial by Leung in this issue.
背景
COVID-19 的长期肺部后遗症尚不清楚。目的：描述 COVID-19 肺炎 1 年后胸部 CT 异常的改善模式和速度。材料与方法：这是一项前瞻性、多中心观察队列研究的二次分析，该研究于 2020 年 4 月 29 日至 8 月 12 日进行，评估 COVID-19 症状出现后约 2、3、6 个月和 1 年时胸部 CT 的肺部异常。使用范围从 0（正常）到 25（所有肺叶受累）的定性 CT 严重程度评分（CTSS）对每个肺叶的肺部发现进行分级。使用逻辑回归评估 1 年后与 CT 异常相关的人口统计学和临床因素。使用弗里德曼检验研究随访 CT 时 CTSS 的变化率。结果：在 142 名入组参与者中，91 名接受了 1 年的随访 CT 检查并纳入分析（平均年龄 59 岁±13[标准差]；35 名女性[38%]）。在 91 名参与者中的 49 名（54%）中观察到 CT 异常：31 名参与者（34%）出现轻微胸膜下网状结构、磨玻璃影或两者兼有，18 名参与者（20%）出现广泛磨玻璃影、网状结构、支气管扩张、微囊变或组合。多变量分析显示，年龄大于 60 岁（比值比[OR]，5.8；95%CI：1.7，24； =.009）、COVID-19 严重程度为危重症（OR，29；95%CI：4.8，280； <.001）和男性（OR，8.9；95%CI：2.6，36； <.001）与 1 年随访时持续 CT 异常相关。在随后的随访 CT 中观察到 CTSS 降低（ <.001）；在研究期间，49%（142 名参与者中的 69 名）的参与者 CT 异常完全消退。49 名 CT 异常参与者中有 31 名（63%）在 6 个月后无进一步改善。结论：COVID-19 肺炎 1 年后 CT 异常很常见。©RSNA，2022 本期杂志还刊登了 Leung 的社论。
Zotero 插件