van Wincoop Maureen, Moeniralam Hazra S, Schramel Franz M N H
Department of Intensive Care, St. Antonius Hospital, Nieuwegein, The Netherlands,
Department of Internal Medicine, St. Antonius Hospital, Nieuwegein, The Netherlands,
Respiration. 2024;103(5):233-250. doi: 10.1159/000535391. Epub 2024 Feb 28.
Many COVID-19 survivors suffer from persisting sequelae after acute disease. This is referred to as long COVID. The objectives of this study were to assess factors associated with long COVID and to analyze differences in persistent symptoms, findings on chest imaging, and pulmonary function between intensive care unit (ICU) and non-ICU hospitalized patients.
We conducted a retrospective study including patients hospitalized with COVID-19. Patients were stratified into ICU patients and non-ICU patients. We analyzed the outcomes of patients who were in clinical follow-up 6 months after discharge with persistent symptoms, radiological and/or functional abnormalities. Logistic regression was used to examine the association between long COVID and patient characteristics.
A total of 549 patients were included. Eighty-one ICU patients (66%) and 146 (34%) non-ICU patients had persistent symptoms or abnormalities on chest imaging or lung function test minimally 6 months after discharge. Significantly more ICU patients had residual fibrotic abnormalities on chest CT and functional impairment. Female gender, myocardial infarction, OSAS, low PCO2 at admission, and longer hospital stay were associated with a higher risk of developing long COVID. Diabetes and treatment with tocilizumab were associated with a lower risk of developing long COVID.
Of the patients hospitalized for COVID-19, 34-66% suffered from persistent symptoms, residual abnormalities on chest imaging, or reduced lung function at around 6 months after discharge. While persistent sequelae were more frequent in ICU patients, admission to the ICU was not found to be an independent risk factor for developing long COVID.
许多新冠病毒病（COVID-19）幸存者在急性病后会出现持续的后遗症。这被称为“长新冠”。本研究的目的是评估与“长新冠”相关的因素，并分析重症监护病房（ICU）和非ICU住院患者在持续症状、胸部影像学表现及肺功能方面的差异。
我们进行了一项回顾性研究，纳入了因COVID-19住院的患者。将患者分为ICU患者和非ICU患者。我们分析了出院后6个月进行临床随访且有持续症状、放射学和/或功能异常的患者的结局。采用逻辑回归分析“长新冠”与患者特征之间的关联。
共纳入549例患者。81例（66%）ICU患者和146例（34%）非ICU患者在出院后至少6个月有持续症状或胸部影像学或肺功能检查异常。显著更多的ICU患者胸部CT有残留纤维化异常及功能损害。女性、心肌梗死、阻塞性睡眠呼吸暂停低通气综合征（OSAS）、入院时低二氧化碳分压及住院时间较长与发生“长新冠”的风险较高相关。糖尿病和使用托珠单抗治疗与发生“长新冠”的风险较低相关。
在因COVID-19住院的患者中，34% - 66%在出院后约6个月有持续症状、胸部影像学残留异常或肺功能下降。虽然ICU患者的持续后遗症更常见，但未发现入住ICU是发生“长新冠”的独立危险因素。
