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未接种疫苗的长期新冠患者在重度和中度肺炎后长达7个月仍遗留什么问题?一项CT研究的结果

What Remains up to 7 Months after Severe and Moderate Pneumonia in Non-Vaccinated Patients with Long COVID? Results of a CT Study.

作者信息

Kurys-Denis Ewa, Grzywa-Celińska Anna, Podgórska Katarzyna, Kawa Miłosz Piotr

机构信息

2nd Department of Radiology, Medical University of Lublin, 20-059 Lublin, Poland.

Chair and Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, 20-059 Lublin, Poland.

出版信息

J Clin Med. 2023 Aug 19;12(16):5388. doi: 10.3390/jcm12165388.

Abstract

BACKGROUND

There is a growing evidence of long-lasting lung changes after COVID-19. Our aim was to assess the degree of lung injury and evaluate the recovery process of 4-7-month-non-vaccinated convalescent patients discharged from hospital after moderate and severe COVID-19 pneumonia, who presented with symptoms of long-COVID.

METHODS

On control lung CT after mean 5-month recovery period, we classified and determined the prevalence of residual radiological abnormalities in 39 symptomatic patients. To assess the advancement of the persisting changes we used the total severity score (TSS) and the chest CT score and then correlated the results with clinical data.

RESULTS AND CONCLUSIONS

On follow-up CT images, 94.9% of patients showed persistent radiological abnormalities. The most frequent changes were ground-glass opacities (74.4%), reticular pattern (64.1%), fibrotic changes (53.8%), nodules (33.3%), bronchiectasis (15.4%), vascular enlargement (10.3%), and cavitation (5.1%). The median TSS score was 4.1 points (interquartile range 3), whereas the median of the chest CT score 5.4 points (interquartile range of 4.5). No significant differences were observed between sex subgroups and between the severe and moderate course groups. There were no association between both CT scores and the severity of the initial disease, indicating that, mean 5 months after the disease, pulmonary abnormalities reduced to a similar stage in both subgroups of severity.

摘要

背景

越来越多的证据表明,新型冠状病毒肺炎(COVID-19)后肺部会出现长期变化。我们的目的是评估中重度COVID-19肺炎出院后4至7个月未接种疫苗的恢复期患者的肺损伤程度,并评估其恢复过程,这些患者出现了长期COVID的症状。

方法

在平均5个月的恢复期后进行对照肺部CT检查,我们对39例有症状患者的残留放射学异常进行分类并确定其患病率。为了评估持续变化的进展情况,我们使用了总严重程度评分(TSS)和胸部CT评分,然后将结果与临床数据进行关联。

结果与结论

在随访CT图像上,94.9%的患者显示出持续的放射学异常。最常见的变化是磨玻璃影(74.4%)、网状影(64.1%)、纤维化改变(53.8%)、结节(33.3%)、支气管扩张(15.4%)、血管增粗(10.3%)和空洞形成(5.1%)。TSS评分中位数为4.1分(四分位间距为3),而胸部CT评分中位数为5.4分(四分位间距为4.5)。在性别亚组之间以及重症和中症病程组之间未观察到显著差异。两个CT评分与初始疾病的严重程度之间均无关联,这表明在疾病发生后平均5个月,两个严重程度亚组的肺部异常均减轻到相似阶段。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d289/10455364/1e742efa52af/jcm-12-05388-g001.jpg

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