From the Robarts Research Institute (H.K.K., M.J.M., A.M.M., G.P.), Department of Medical Biophysics (H.K.K., M.J.M., A.M.M., G.P.), Department of Medical Imaging (M.A., G.P.), Division of Respirology, Department of Medicine (I.D., J.M.N., G.P.), and Department of Physics and Astronomy (A.O.), Western University, 1151 Richmond St N, London, ON, Canada N6A 5B7; Department of Chemistry, Lakehead University, Thunder Bay, Canada (M.S.A.); Department of Physics, Toronto Metropolitan University, Toronto, Canada (M.K.); Translational Medicine Program, Hospital for Sick Children, Toronto, Canada (G.E.S.); and Division of Respirology, Department of Medicine, McMaster University and Firestone Institute for Respiratory Health, St Joseph's Health Care, Hamilton, Canada (C.V., N.R., S.S.).
Radiology. 2023 Apr;307(2):e222557. doi: 10.1148/radiol.222557. Epub 2023 Feb 7.
Background In individuals with postacute COVID-19 syndrome (PACS) and normal pulmonary function, xenon 129 (Xe) MRI ventilation defects, abnormal quality-of-life scores, and exercise limitation were reported 3 months after infection; the longitudinal trajectory remains unclear. Purpose To measure and compare pulmonary function, exercise capacity, quality of life, and Xe MRI ventilation defect percent (VDP) in individuals with PACS evaluated 3 and 15 months after COVID-19 infection. Materials and Methods In this prospective study, participants with PACS aged 18-80 years were enrolled between July 2020 and August 2021 from two quaternary care centers. Xe MRI VDP, diffusing capacity of lung for carbon monoxide (Dlco), spirometry, oscillometry, 6-minute walk distance (6MWD), and St George Respiratory Questionnaire (SGRQ) scores were evaluated 3 months and 15 months after COVID-19 infection. Differences between time points were evaluated using the paired test. Multivariable models were generated to explain exercise capacity and quality-of-life improvement. Odds ratios (ORs) were used to evaluate potential treatment influences. Results Overall, 53 participants (mean age, 55 years ± 18 [SD]; 27 women) attended both 3- and 15-month visits and were included in the analysis. The mean values for Xe MRI VDP (5.8% and 4.2%; = .003), forced expiratory volume in the 1st second of expiration percent predicted (84% and 90%; = .001), Dlco percent predicted (86% and 99%; = .002), and SGRQ score (35 and 25; < .001) improved between the 3- and 15-month visit. VDP measured 3 months after COVID-19 infection predicted the change in 6MWD (β = -0.643, = .006), while treatment with respiratory medication at 3 months predicted an improved quality-of-life score at 15 months (OR, 4.0; 95% CI: 1.2, 13.8; = .03). Conclusion Pulmonary function, gas exchange, exercise capacity, quality of life, and Xe MRI ventilation defect percent (VDP) improved in participants with postacute COVID-19 syndrome at 15 months compared with 3 months after infection. VDP measured at 3 months after infection correlated with improved exercise capacity, while treatment with respiratory medication was associated with an improved quality-of-life score 15 months after infection. ClinicalTrials.gov registration no. NCT05014516 © RSNA, 2023 See also the editorial by Vogel-Claussen in this issue.
背景 在患有急性新冠后综合征 (PACS) 且肺功能正常的个体中，有人报告称，在感染后 3 个月时，氙 129（Xe）MRI 通气缺陷、生活质量评分异常和运动受限；但纵向轨迹仍不清楚。目的 测量和比较感染新冠后 3 个月和 15 个月时患有 PACS 的个体的肺功能、运动能力、生活质量和 Xe MRI 通气缺陷百分比（VDP）。材料与方法 本前瞻性研究纳入了 2020 年 7 月至 2021 年 8 月期间来自两家四级护理中心的年龄在 18-80 岁的患有 PACS 的个体。在感染新冠后 3 个月和 15 个月评估 Xe MRI VDP、一氧化碳弥散量（Dlco）、肺活量测定、振荡法、6 分钟步行距离（6MWD）和圣乔治呼吸问卷（SGRQ）评分。使用配对 t 检验评估各时间点之间的差异。生成多变量模型以解释运动能力和生活质量的改善。使用比值比（OR）评估潜在治疗影响。结果 共有 53 名（平均年龄，55 岁±18[标准差]；27 名女性）参与者在感染后 3 个月和 15 个月时参加了两次就诊，并被纳入分析。Xe MRI VDP（5.8%和 4.2%； =.003）、用力呼气量占预计值的百分比（84%和 90%； =.001）、Dlco 占预计值的百分比（86%和 99%； =.002）和 SGRQ 评分（35 和 25； <.001）在 3 个月和 15 个月时都有所改善。感染新冠后 3 个月时测量的 VDP 预测了 6MWD 的变化（β=-0.643， =.006），而在 3 个月时接受呼吸药物治疗预测了 15 个月时生活质量评分的改善（比值比，4.0；95%置信区间：1.2，13.8； =.03）。结论 与感染后 3 个月相比，患有急性新冠后综合征的个体在感染后 15 个月时的肺功能、气体交换、运动能力、生活质量和 Xe MRI 通气缺陷百分比（VDP）都有所改善。感染后 3 个月时测量的 VDP 与运动能力的改善相关，而在感染后 15 个月时接受呼吸药物治疗与生活质量评分的改善相关。ClinicalTrials.gov 注册号 NCT05014516 © RSNA，2023 另见本期由 Vogel-Claussen 撰写的社论。
