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新冠病毒感染后早期的症状和影像学表现:老年患者与年轻患者的对比研究。

Symptomatology and imaging findings in early post-Covid period: A comparative study in older vs younger patients.

机构信息

Istanbul University Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics, Istanbul, Turkiye.

Istanbul University Istanbul Faculty of Medicine, Department of Internal Medicine, Istanbul, Turkiye.

出版信息

Exp Gerontol. 2022 Oct 1;167:111907. doi: 10.1016/j.exger.2022.111907. Epub 2022 Aug 6.

Abstract

BACKGROUND

While there are substantial reports on the acute phase of Covid-19, the data on post-Covid phase are limited.

AIM

To report the data on older post-Covid patients comparatively with the young adults.

STUDY DESIGN

Retrospective, single-center study in post-Covid outpatient clinic. Clinical characteristics, laboratory examination, chest imagings were examined.

RESULTS

665 patients were included (median age, 46; 53 %, male; 10.5 %, aged ≥65). We assessed patients at 47th day (median) after recovery. 43.6 % were suffering from one or more ongoing symptomatology. The prevalence of symptoms or physical examination findings were not different between older and younger groups. Most prevalent ongoing symptom was dyspnea (14.3 % and 11.8 % older and younger group, respectively). Most common laboratory abnormality was high pro-BNP (12.2 %, in both age groups). Despite there was no differences regarding imaging findings at acute-phase, there were higher rates of control imaging abnormalities in older subgroup (35.7 % vs 19.4 %; p = 0.006). On admission 28.4 % younger patients had normal imaging, of whom 12.4 % developed some form of sequela; however, in older group, 40.0 % had normal imaging, of whom 25.0 % developed sequela.

CONCLUSION

Complaints related to Covid-19 persisted in about half of the patients at about 1.5 months after Covid. More than 1/3 older post-Covid patients displayed pulmonary sequela in the post-acute period which was more prevalent than those in younger adults. Hence, compared to the younger counterparts, the clinicians should be alert in follow-up of older adults for subsequent pulmonary sequela, even among those that had normal imaging finding on initial presentation.

摘要

背景

虽然有大量关于新冠急性阶段的报告,但关于新冠后阶段的数据有限。

目的

报告与年轻成年人相比,老年新冠后患者的数据。

研究设计

在新冠门诊进行回顾性、单中心研究。检查了临床特征、实验室检查和胸部影像学。

结果

共纳入 665 例患者(中位年龄 46 岁;53%为男性;10.5%年龄≥65 岁)。我们在康复后第 47 天(中位数)评估了患者。43.6%的患者存在一种或多种持续的症状。老年组和年轻组之间,症状或体格检查结果的发生率没有差异。持续存在的最常见症状是呼吸困难(老年组和年轻组分别为 14.3%和 11.8%)。最常见的实验室异常是高敏脑钠肽前体(12.2%,在两个年龄组中)。尽管在急性期影像学检查无差异,但老年亚组的控制影像学异常发生率更高(35.7%比 19.4%;p=0.006)。在入院时,28.4%的年轻患者的影像学检查正常,其中 12.4%发展为某种后遗症;然而,在老年组中,40.0%的影像学检查正常,其中 25.0%发展为后遗症。

结论

在新冠后约 1.5 个月,约一半的患者仍存在与新冠相关的症状。超过 1/3的老年新冠后患者在急性后期出现肺部后遗症,比年轻成年人更常见。因此,与年轻患者相比,临床医生应在随访老年患者时保持警惕,即使在初始表现正常影像学的患者中,也应警惕后续肺部后遗症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d29f/9355744/9a4ec2ffb578/gr1_lrg.jpg

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