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中国 COVID-19 肺炎患者 6 个月随访的 CT 评估。

CT-based Assessment at 6-Month Follow-up of COVID-19 Pneumonia patients in China.

机构信息

Department of Radiology, the 305 Hospital of PLA, 13 Wenjin Street, Beijing, 100017, China.

Medical Department of General Surgery, Chinese PLA General Hospital, The 1St Medical Center, Beijing, 100853, China.

出版信息

Sci Rep. 2024 Feb 29;14(1):5028. doi: 10.1038/s41598-024-54920-1.

Abstract

This study aimed to assess pulmonary changes at 6-month follow-up CT and predictors of pulmonary residual abnormalities and fibrotic-like changes in COVID-19 pneumonia patients in China following relaxation of COVID restrictions in 2022. A total of 271 hospitalized patients with COVID-19 pneumonia admitted between November 29, 2022 and February 10, 2023 were prospectively evaluated at 6 months. CT characteristics and Chest CT scores of pulmonary abnormalities were compared between the initial and the 6-month CT. The association of demographic and clinical factors with CT residual abnormalities or fibrotic-like changes were assessed using logistic regression. Follow-up CT scans were obtained at a median of 177 days (IQR, 170-185 days) after hospital admission. Pulmonary residual abnormalities and fibrotic-like changes were found in 98 (36.2%) and 39 (14.4%) participants. In multivariable analysis of pulmonary residual abnormalities and fibrotic-like changes, the top three predictive factors were invasive ventilation (OR 13.6; 95% CI 1.9, 45; P < .001), age > 60 years (OR 9.1; 95% CI 2.3, 39; P = .01), paxlovid (OR 0.11; 95% CI 0.04, 0.48; P = .01) and invasive ventilation (OR 10.3; 95% CI 2.9, 33; P = .002), paxlovid (OR 0.1; 95% CI 0.03, 0.48; P = .01), smoker (OR 9.9; 95% CI 2.4, 31; P = .01), respectively. The 6-month follow-up CT of recent COVID-19 pneumonia cases in China showed a considerable proportion of the patients with pulmonary residual abnormalities and fibrotic-like changes. Antivirals against SARS-CoV-2 like paxlovid may be beneficial for long-term regression of COVID-19 pneumonia.

摘要

这项研究旨在评估中国 2022 年放松 COVID 限制后,271 例因 COVID-19 住院的肺炎患者在 6 个月时的 CT 随访结果,以及预测 COVID-19 肺炎患者肺残留异常和纤维化样改变的因素。这些患者于 2022 年 11 月 29 日至 2023 年 2 月 10 日期间住院,前瞻性评估他们在 6 个月时的 CT 特征和肺异常的胸部 CT 评分。采用逻辑回归评估人口统计学和临床因素与 CT 残留异常或纤维化样改变的相关性。中位随访时间为住院后 177 天(IQR,170-185 天)。98 名(36.2%)和 39 名(14.4%)患者存在肺残留异常和纤维化样改变。在多变量分析中,肺残留异常和纤维化样改变的前三个预测因素是有创通气(OR 13.6;95%CI 1.9,45;P<.001)、年龄>60 岁(OR 9.1;95%CI 2.3,39;P=.01)、paxlovid(OR 0.11;95%CI 0.04,0.48;P=.01)和有创通气(OR 10.3;95%CI 2.9,33;P=.002)、paxlovid(OR 0.1;95%CI 0.03,0.48;P=.01)、吸烟者(OR 9.9;95%CI 2.4,31;P=.01)。中国近期 COVID-19 肺炎病例的 6 个月随访 CT 显示,相当比例的患者存在肺残留异常和纤维化样改变。抗 SARS-CoV-2 的抗病毒药物如 paxlovid 可能对 COVID-19 肺炎的长期消退有益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c87/10904828/ea4a501dc4db/41598_2024_54920_Fig1_HTML.jpg

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