Department of Internal Medicine, Sengkang General Hospital, Singapore, Singapore.
Department of Respiratory Medicine, Sengkang General Hospital, Singapore, Singapore.
Sci Rep. 2023 Oct 12;13(1):17275. doi: 10.1038/s41598-023-43710-w.
Post-COVID-19 pulmonary sequalae are well-recognized early in the pandemic. Survivorship clinics are crucial for managing at-risk patients. However, it is unclear who requires pulmonary function test (PFT) and when PFTs should be performed. We aim to investigate for whom and how these interval PFTs should be performed. We performed a single-centre, prospective cohort study on COVID-19 survivors between 1st May 2020 and 31st April 2022. These patients were followed up at 6, 9 and 12 months with interval PFT and Short Form-36 (SF-36) Health Survey. Those with PFT defects were offered a computed tomography scan of the thorax. Of the 46 patients recruited, 17 (37%) had severe/critical illness. Compared to those with mild/moderate disease, these patients were more likely to experience DLCO defects (59% versus 17%, p = 0.005) and had lower SF-36 scores (mean physical component summary score of 45 ± 12 versus 52 ± 8, p = 0.046). These differences were most notable at 6 months, compared to the 9- and 12-months intervals. DLCO defects were also associated with older age, raised inflammatory markers and extensive CXR infiltrates. Besides interstitial-like abnormalities, obesity and undiagnosed lung conditions accounted for 39% of the PFT abnormalities. Interval PFTs can be performed earliest 6 months post-COVID-19. Patients with normal tests were unlikely to develop new abnormalities and would not require repeat PFTs. Abnormal PFTs can be followed-up with repeat PFTs 6 monthly until resolution. Non-COVID-19 differentials should be considered for persistent PFT abnormalities.
新冠病毒感染后肺部后遗症在疫情早期就已被广泛认识。生存者诊所对于管理高危患者至关重要。然而,目前尚不清楚哪些患者需要进行肺功能测试(PFT)以及何时进行 PFT。我们旨在研究应该为哪些患者以及如何进行这些间隔性 PFT。我们对 2020 年 5 月 1 日至 2022 年 4 月 31 日期间的新冠病毒感染幸存者进行了一项单中心前瞻性队列研究。这些患者在 6、9 和 12 个月时接受了间隔性 PFT 和健康调查简表 36 项(SF-36)的随访。对于 PFT 异常的患者,我们提供了胸部计算机断层扫描检查。在招募的 46 名患者中,17 名(37%)患有重症/危重症。与轻症/中症患者相比,这些患者更有可能出现 DLCO 缺陷(59%比 17%,p=0.005),SF-36 评分更低(平均生理成分综合评分 45±12 比 52±8,p=0.046)。与 9 个月和 12 个月的间隔相比,这些差异在 6 个月时最为明显。DLCO 缺陷也与年龄较大、炎症标志物升高和广泛的胸部 X 线片浸润有关。除了间质性样异常外,肥胖和未确诊的肺部疾病占 PFT 异常的 39%。新冠病毒感染后最早可以在 6 个月时进行间隔性 PFT。如果测试正常,患者不太可能出现新的异常,也不需要重复进行 PFT。对于异常的 PFT,可以每 6 个月进行重复 PFT 以等待其恢复。对于持续性 PFT 异常,应考虑非新冠病毒感染的鉴别诊断。