Lee Inhan, Kim Joohae, Yeo Yohwan, Lee Ji Yeon, Jeong Ina, Joh Joon-Sung, Kim Gayeon, Chin Bum Sik, Kim Yeonjae, Kim Min-Kyung, Jeon Jaehyun, Yoon Yup, Jin Sung Chan, Kim Junghyun
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Medical Center, Seoul 04564, Korea.
Department of Family Medicine, College of Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong 18450, Korea.
J Clin Med. 2022 Oct 7;11(19):5913. doi: 10.3390/jcm11195913.
The frequency and clinical manifestation of lung fibrosis accompanied by coronavirus disease (COVID-19) are not well-established. We aimed to identify the factors attributed to post-COVID-19 fibrosis. This single-center prospective study included patients diagnosed with COVID-19 pneumonia from 12 April to 22 October 2021 in the Republic of Korea. The primary outcome was the presence of pulmonary fibrosis on a CT scan 3 months after discharge; the fibrosis risk was estimated by a multiple logistic regression. The mean patient age was 55.03 ± 12.32 (range 27-85) years; 65 (66.3%) were men and 33 (33.7%) were women. The age, Charlson Comorbidity Index, lactate dehydrogenase level, aspartate aminotransferase level, and Krebs von den Lungen-6 level were significantly higher and the albumin level and the saturation of the peripheral oxygen/fraction of inspired oxygen (SpO/FiO) ratio were significantly lower in the fibrosis group than in the non-fibrosis group; the need for initial oxygen support was also greater in the fibrosis group. An older age (adjusted odds ratio (AOR) 1.12; 95% confidence interval (CI) 1.03-1.21) and a lower initial SpO/FiO ratio (AOR 7.17; 95% CI 1.72-29.91) were significant independent risk factors for pulmonary fibrosis after COVID-19 pneumonia. An older age and a low initial SpO/FiO ratio were crucial in predicting pulmonary fibrosis after COVID-19 pneumonia.
新型冠状病毒肺炎(COVID-19)相关肺纤维化的发生率及临床表现尚不明确。我们旨在确定导致COVID-19后肺纤维化的因素。这项单中心前瞻性研究纳入了2021年4月12日至10月22日在韩国被诊断为COVID-19肺炎的患者。主要结局是出院后3个月CT扫描显示存在肺纤维化;通过多因素逻辑回归评估纤维化风险。患者的平均年龄为55.03±12.32(范围27 - 85)岁;男性65例(66.3%),女性33例(33.7%)。纤维化组的年龄、查尔森合并症指数、乳酸脱氢酶水平、天冬氨酸转氨酶水平和Krebs von den Lungen-6水平显著高于非纤维化组,而白蛋白水平和外周血氧饱和度/吸入氧分数(SpO/FiO)比值显著低于非纤维化组;纤维化组对初始氧疗的需求也更大。年龄较大(校正比值比(AOR)1.12;95%置信区间(CI)1.03 - 1.21)和初始SpO/FiO比值较低(AOR 7.17;95%CI 1.72 - 29.91)是COVID-19肺炎后肺纤维化的显著独立危险因素。年龄较大和初始SpO/FiO比值较低对预测COVID-19肺炎后肺纤维化至关重要。