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肺部受累是新冠后综合征的一种独特表型吗?

Is Pulmonary Involvement a Distinct Phenotype of Post-COVID-19?

作者信息

Bartczak Krystian T, Miłkowska-Dymanowska Joanna, Pietrusińska Małgorzata, Kumor-Kisielewska Anna, Stańczyk Adam, Majewski Sebastian, Piotrowski Wojciech J, Lipiński Cezary, Wawrocki Sebastian, Białas Adam J

机构信息

Department of Pneumology, Medical University of Lodz, 90-153 Lodz, Poland.

Department of Clinical Pharmacology, Medical University of Lodz, 90-153 Lodz, Poland.

出版信息

Biomedicines. 2023 Oct 2;11(10):2694. doi: 10.3390/biomedicines11102694.

Abstract

(1) Background: COVID-19 infection often provokes symptoms lasting many months: most commonly fatigue, dyspnea, myalgia and mental distress symptoms. In this study, we searched for clinical features of post-COVID-19 condition (PCC) and differences between patients with and without pulmonary involvement. (2) Methods: A total of 282 patients with a mean age of 57 years (SD +/- 12 years) underwent assessment up to 12 weeks after COVID-19 recovery. The course of acute disease, past medical history and clinical symptoms were gathered; pulmonary function tests were performed; radiographic studies were assessed and follow-up examinations were conducted. Patients with and without detectable pulmonary lesions were divided into separate groups. (3) Results: Patients within the pulmonary group were more often older (59 vs. 51 y.o.; < 0.001) males ( = 0.002) that underwent COVID-19-related hospitalization ( < 0.001) and were either ex- or active smokers with the median of 20 pack-years. We also managed to find correlations with hypertension ( = 0.01), liver failure ( = 0.03), clinical symptoms such as dyspnea ( < 0.001), myalgia ( = 0.04), headache ( = 0.009), sleeplessness ( = 0.046), pulmonary function tests (such as FVC, TLCO, RV and TLC; < 0.001) and several basic laboratory tests (D-dimer, cardiac troponin, WBC, creatinine and others). (4) Conclusions: Our results indicate that initial pulmonary involvement alters the PCC, and it can be used to individualize clinical approaches.

摘要

(1)背景:新型冠状病毒肺炎(COVID-19)感染常引发持续数月的症状:最常见的是疲劳、呼吸困难、肌痛和精神困扰症状。在本研究中,我们探寻了COVID-19后状况(PCC)的临床特征以及有和无肺部受累患者之间的差异。(2)方法:共有282例平均年龄为57岁(标准差±12岁)的患者在COVID-19康复后长达12周接受评估。收集急性病病程、既往病史和临床症状;进行肺功能测试;评估影像学检查并开展随访检查。有和无可检测到肺部病变的患者被分为不同组。(3)结果:肺部病变组患者年龄更大(59岁对51岁;P<0.001)、男性更多(P = 0.002),曾因COVID-19住院(P<0.001),且为既往或现吸烟者,吸烟史中位数为20包年。我们还发现与高血压(P = 0.01)、肝功能衰竭(P = 0.03)、呼吸困难(P<0.001)、肌痛(P = 0.04)、头痛(P = 0.009)、失眠(P = 0.046)等临床症状、肺功能测试(如用力肺活量、肺一氧化碳弥散量、残气量和肺总量;P<0.001)以及多项基础实验室检查(D-二聚体、心肌肌钙蛋白、白细胞、肌酐等)存在相关性。(4)结论:我们的结果表明,初始肺部受累会改变PCC,可用于个体化临床治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dbd2/10604471/dac6babbef79/biomedicines-11-02694-g001.jpg

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