Pulmonary Department, Hospital Clínico, and.
Laboratory of Biochemistry and Molecular Pathology, Hospital Clínico de Valencia, Valencia, Spain.
Am J Respir Cell Mol Biol. 2023 Sep;69(3):321-327. doi: 10.1165/rcmb.2022-0474OC.
Beyond the acute infection of coronavirus disease (COVID-19), concern has arisen about long-term effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The aim of our study was to analyze if there is any biomarker of fibrogenesis in patients with COVID-19 pneumonia capable of predicting post-COVID-19 pulmonary sequelae. We conducted a multicenter, prospective, observational cohort study of patients admitted to a hospital with bilateral COVID-19 pneumonia. We classified patients into two groups according to severity, and blood sampling to measure matrix metalloproteinase 1 (MMP-1), MMP-7, periostin, and VEGF and respiratory function tests and high-resolution computed tomography were performed at 2 and 12 months after hospital discharge. A total of 135 patients were evaluated at 12 months. Their median age was 61 (interquartile range, 19) years, and 58.5% were men. We found between-group differences in age, radiological involvement, length of hospital stay, and inflammatory laboratory parameters. Differences were found between 2 and 12 months in all functional tests, including improvements in predicted forced vital capacity (98.0% vs. 103.9%; = 0.001) and Dl <80% (60.9% vs. 39.7%; = 0.001). At 12 months, 63% of patients had complete high-resolution computed tomography resolution, but fibrotic changes persisted in 29.4%. Biomarker analysis demonstrated differences at 2 months in periostin (0.8893 vs. 1.437 ng/ml; < 0.001) and MMP-7 (8.7249 vs. 15.2181 ng/ml; < 0.001). No differences were found at 12 months. In multivariable analysis, only 2-month periostin was associated with 12-month fibrotic changes (odds ratio, 1.0013; 95% confidence interval, 1.0006-1.00231; = 0.003) and 12-month Dl impairment (odds ratio, 1.0006; 95% confidence interval, 1.0000-1.0013; = 0.047). Our data suggest that early periostin postdischarge could predict the presence of fibrotic pulmonary changes.
除了冠状病毒病 (COVID-19) 的急性感染外，人们还对严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 感染的长期影响表示关注。我们研究的目的是分析 COVID-19 肺炎患者中是否存在纤维化生物标志物，以预测 COVID-19 后肺部后遗症。我们进行了一项多中心、前瞻性、观察性队列研究，纳入了因双侧 COVID-19 肺炎住院的患者。我们根据严重程度将患者分为两组，并进行血液采样以测量基质金属蛋白酶 1 (MMP-1)、MMP-7、骨膜蛋白和 VEGF，并在出院后 2 个月和 12 个月进行呼吸功能测试和高分辨率计算机断层扫描。共有 135 名患者在 12 个月时进行了评估。他们的中位年龄为 61（四分位距 19）岁，58.5%为男性。我们发现两组之间在年龄、影像学受累、住院时间和炎症实验室参数方面存在差异。所有功能测试在 2 个月至 12 个月之间均存在差异，包括预计用力肺活量的改善（98.0%比 103.9%； = 0.001）和 Dl <80%（60.9%比 39.7%； = 0.001）。12 个月时，63%的患者完全恢复了高分辨率计算机断层扫描分辨率，但仍有 29.4%存在纤维化改变。生物标志物分析显示，2 个月时骨膜蛋白（0.8893 比 1.437ng/ml； < 0.001）和 MMP-7（8.7249 比 15.2181ng/ml； < 0.001）存在差异。12 个月时无差异。多变量分析显示，只有 2 个月时的骨膜蛋白与 12 个月时的纤维化改变（比值比，1.0013；95%置信区间，1.0006-1.00231； = 0.003）和 12 个月时的 Dl 损害（比值比，1.0006；95%置信区间，1.0000-1.0013； = 0.047）相关。我们的数据表明，出院后早期的骨膜蛋白可能预测存在纤维化肺部改变。
