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长新冠的临床和影像学结果:新冠后纤维化是否常见?

Clinical and radiological outcomes of longCOVID: Is the post-COVID fibrosis common?

机构信息

Department of Pulmonology, Balıkesir University Faculty of Medicine, Balıkesir, Türkiye.

Department of Radiology, Balıkesir University Faculty of Medicine, Balıkesir, Türkiye.

出版信息

Tuberk Toraks. 2023 Mar;71(1):48-57. doi: 10.5578/tt.20239907.

DOI:10.5578/tt.20239907
PMID:36912409
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10795271/
Abstract

INTRODUCTION

COVID-19 survivors may take longer to regain full well-being. This study aimed to investigate clinical and functional evaluation and radiologic changes in the third month after COVID-19.

MATERIALS AND METHODS

A total of 126 patients were assessed in the third month for symptoms, pulmonary function, exercise capacity, radiologic imaging, and quality of life after being discharged following COVID-19 treatment. Two radiologists evaluated the initial and follow-up images.

RESULT

At the third month follow-up visit, the most common persisting symptoms were shortness of breath (32.5%), cough (12.7%), and muscle pain (12.7%). At the follow-up visit, oxygen saturations at rest and after a sixmin walking test were lower in patients with prior intensive care hospitalization compared to those without (p<0.001, p= 0.004). Computed tomography (CT) scans revealed persisting pulmonary pathologies in 64.6% of patients at the third month follow-up. The most common pathologies on follow-up thoracic CT were fibrotic-like changes in 44.2% and ground-glass opacities (GGO) in 33.3%. Regression analysis unveiled that age [95% confidence interval (CI), 1.01 to 1.15; p= 0.020], male sex (95% CI, 4.06 to 95.3, p<0.001), first CT severity score (95% CI, 1.02 to 1.41, p= 0.028), duration of hospitalization (95% CI, 1.02 to 1.18, p= 0.012), oxygen saturation (95% CI, 0.86 to 0.96, p<0.001) were independent predictors of fibrotic-like changes.

CONCLUSIONS

In the third month following COVID-19, the most common symptom was dyspnea, and the most common radiological findings were fibrotic-like changes and GGO. Longer follow-up studies of COVID-19 survivors are needed to observe lasting changes.

摘要

简介

COVID-19 幸存者可能需要更长时间才能完全恢复健康。本研究旨在调查 COVID-19 治疗后出院后第三个月的临床和功能评估以及影像学变化。

材料和方法

共有 126 名患者在第三个月接受了症状、肺功能、运动能力、影像学和 COVID-19 治疗后生活质量的评估。两名放射科医生评估了初始和随访图像。

结果

在第三个月的随访中,最常见的持续症状是呼吸急促(32.5%)、咳嗽(12.7%)和肌肉疼痛(12.7%)。在随访时,与未住院的患者相比,有重症监护住院史的患者静息和六分钟步行试验后的血氧饱和度较低(p<0.001,p=0.004)。在第三个月的随访中,64.6%的患者的 CT 扫描显示持续的肺部病变。在随访的胸部 CT 中,最常见的病变是纤维化样改变(44.2%)和磨玻璃影(GGO)(33.3%)。回归分析显示年龄[95%置信区间(CI),1.01 至 1.15;p=0.020]、男性(95% CI,4.06 至 95.3,p<0.001)、首次 CT 严重程度评分(95% CI,1.02 至 1.41,p=0.028)、住院时间(95% CI,1.02 至 1.18,p=0.012)、血氧饱和度(95% CI,0.86 至 0.96,p<0.001)是纤维化样改变的独立预测因子。

结论

在 COVID-19 后的第三个月,最常见的症状是呼吸困难,最常见的影像学表现是纤维化样改变和 GGO。需要对 COVID-19 幸存者进行更长时间的随访研究,以观察持续的变化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9907/10795271/88dc7ad7fcc7/48-57-figure6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9907/10795271/d463ffbb734e/48-57-figure1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9907/10795271/0a1c9d7b798e/48-57-figure2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9907/10795271/4c58900f2cf6/48-57-figure3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9907/10795271/2887284d97d7/48-57-figure4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9907/10795271/2e0730c5b83e/48-57-figure5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9907/10795271/88dc7ad7fcc7/48-57-figure6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9907/10795271/d463ffbb734e/48-57-figure1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9907/10795271/0a1c9d7b798e/48-57-figure2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9907/10795271/4c58900f2cf6/48-57-figure3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9907/10795271/2887284d97d7/48-57-figure4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9907/10795271/2e0730c5b83e/48-57-figure5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9907/10795271/88dc7ad7fcc7/48-57-figure6.jpg

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