前瞻性队列研究：非住院 COVID-19 肺炎幸存者在六个月内的肺功能和生活质量。

Pulmonary function and Quality of Life in a prospective cohort of (non-) hospitalized COVID-19 pneumonia survivors up to six months.

机构信息

Department of Respiratory Medicine, 10215OLVG, Amsterdam, The Netherlands.

Department of Medical Psychiatry, 10215Amsterdam UMC and OLVG, Amsterdam, The Netherlands.

出版信息

Chron Respir Dis. 2022 Jan-Dec;19:14799731221114271. doi: 10.1177/14799731221114271.

DOI:10.1177/14799731221114271

PMID:36367295

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9659768/

Abstract

OBJECTIVES

A decrease of both diffusion capacity (DLCO) and Quality of Life (QoL) was reported after discharge in hospitalized COVID-19 pneumonia survivors. We studied three and 6 month outcomes in hospitalized and non-hospitalized patients.

METHODS

COVID-19 pneumonia survivors ( = 317) were categorized into non-hospitalized "moderate" cases ( = 59), hospitalized "severe" cases ( = 180) and ICU-admitted "critical" cases ( = 39). We studied DLCO and QoL (Short Form SF-36 health survey) 3 and 6 months after discharge. Data were analyzed using (repeated measures) ANOVA, Kruskal-Wallis or Chi-square test ( < .05).

RESULTS

At 3 months DLCO was decreased in 44% of moderate-, 56% of severe- and 82% of critical cases ( < .003). Mean DLCO in critical cases (64±14%) was lower compared to severe (76 ± 17%) and moderate (81±15%) cases ( < .001). A total of 159/278 patients had a decreased DLCO (<80%), of whom the DLCO improved after 6 months in 45% (71/159). However the DLCO did not normalize in the majority (89%) of the cases (63 ± 10% vs 68±10%; < .001). At 3 months, compared to critical cases, moderate cases scored lower on SF-36 domain "general health" ( < .05); both moderate and severe cases scored lower on the domain of "health change" ( < .05). At 6 months, there were no differences in SF-36 between the subgroups. Compared to 3 months, in all groups "physical functioning" improved; in contrast all groups scored significantly lower on "non-physical" SF-36 domains.

CONCLUSION

Three months after COVID-19 pneumonia, DLCO was still decreased in the more severely affected patients, with an incomplete recovery after 6 months. At 3 months QoL was impaired. At 6 months, while "physical functioning" improved, a decrease in "non-physical" QoL was observed but did not differ between the moderate and severely affected patients.

摘要

目的

据报道，COVID-19 肺炎住院幸存者出院后，弥散能力（DLCO）和生活质量（QoL）均下降。我们研究了住院和非住院患者的 3 个月和 6 个月的结果。

方法

将 COVID-19 肺炎幸存者（n=317）分为非住院“中度”病例（n=59）、住院“重度”病例（n=180）和 ICU 收治“危重症”病例（n=39）。我们在出院后 3 个月和 6 个月时研究了 DLCO 和 QoL（SF-36 健康调查短表）。使用（重复测量）方差分析、Kruskal-Wallis 或卡方检验（<0.05）进行数据分析。

结果

在 3 个月时，中度、重度和危重症病例中分别有 44%、56%和 82%的患者 DLCO 下降（<0.003）。危重症病例的平均 DLCO（64±14%）明显低于重度（76±17%）和中度（81±15%）病例（<0.001）。278 例中有 159 例患者 DLCO 下降（<80%），其中 45%（71/159）的患者在 6 个月后 DLCO 得到改善。然而，大多数患者的 DLCO 未恢复正常（89%）（63±10%比 68±10%；<0.001）。在 3 个月时，与危重症病例相比，中度病例 SF-36 领域的“一般健康”得分较低（<0.05）；中度和重度病例的“健康变化”领域得分均较低（<0.05）。在 6 个月时，各组之间的 SF-36 无差异。与 3 个月相比，所有组的“身体机能”都有所改善；相反，所有组的“非身体”SF-36 领域得分均明显降低。