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探索COVID-19中脾肿大与肺部受累的相关性:一项回顾性研究。

Exploring the Correlation Between Splenomegaly and Lung Involvement in COVID-19: A Retrospective Study.

作者信息

Raju Bharathi Priya, Selvaraj Balaji, Murugesan Sharmila, Balasubramaniam Suhasini, Pk Sowmiya, Raviganesh Pravin Kumar, Sivaprakasam Rajasekaran, Balaji Sangeetha, Fernando Rupert Nithin, Ramasubramanian Swaminathan

机构信息

Radiodiagnosis, Government Stanley Medical College and Hospital, Chennai, IND.

Radiodiagnosis, Government Medical College, Omandurar Government Estate, Chennai, IND.

出版信息

Cureus. 2024 Mar 2;16(3):e55415. doi: 10.7759/cureus.55415. eCollection 2024 Mar.

Abstract

Background Coronavirus disease 2019 (COVID-19), resulting from the severe acute respiratory syndrome corona virus 2 (SARS-CoV-2), has not only shown substantial effects on the respiratory system but also on extrapulmonary systems, including cardiovascular, gastrointestinal, hematological, and immune responses, notably spleen enlargement. The connection between the enlargement of the spleen and pulmonary complications in individuals with COVID-19 is still not well elucidated, with current studies offering divergent conclusions. Objective This study aims to elucidate the correlation between splenomegaly, as assessed by computed tomography (CT) imaging, and the extent of lung involvement (LI) in COVID-19 patients, thereby offering insights into potential prognostic indicators. Methodology A hospital-based, cross-sectional, retrospective study was conducted involving 1058 symptomatic COVID-19 patients confirmed by reverse transcriptase-polymerase chain reaction (RT-PCR), aged 18 years and above. CT imaging was utilized to evaluate spleen size and LI. Statistical analyses, including Pearson correlation and simple linear regression, were performed to explore the relationship between spleen size and LI. Results The study cohort exhibited a mean spleen size of 9.49 cm and a mean LI score of 0.272. The Pearson correlation coefficient was calculated at 0.0495, indicating a marginal positive correlation between spleen size and LI. Regression analysis demonstrated a minimal impact of spleen size on LI, with spleen size accounting for only 0.2% of the variance in LI scores. Conclusions The study found a slight, statistically non-significant correlation between splenomegaly and LI in COVID-19 patients, suggesting that while splenic enlargement may reflect systemic disease involvement, it is not a strong independent predictor of lung damage extent. The findings highlight the complexity of extrapulmonary manifestations and highlight the need for additional research to fully understand the implications of splenic involvement in COVID-19.

摘要

背景 2019 冠状病毒病(COVID - 19)由严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)引起,不仅对呼吸系统有显著影响,还对肺外系统产生影响,包括心血管、胃肠道、血液学和免疫反应,尤其是脾脏肿大。COVID - 19 患者脾脏肿大与肺部并发症之间的联系仍未得到充分阐明,目前的研究得出了不同的结论。目的 本研究旨在通过计算机断层扫描(CT)成像评估脾肿大与 COVID - 19 患者肺部受累程度(LI)之间的相关性,从而为潜在的预后指标提供见解。方法 进行了一项基于医院的横断面回顾性研究,纳入 1058 例经逆转录聚合酶链反应(RT-PCR)确诊的 18 岁及以上有症状的 COVID - 19 患者。利用 CT 成像评估脾脏大小和 LI。进行了包括 Pearson 相关性分析和简单线性回归在内的统计分析,以探讨脾脏大小与 LI 之间的关系。结果 研究队列的脾脏平均大小为 9.49 cm,LI 平均评分为 0.272。计算得出 Pearson 相关系数为 0.0495,表明脾脏大小与 LI 之间存在微弱的正相关。回归分析表明脾脏大小对 LI 的影响极小,脾脏大小仅占 LI 评分方差的 0.2%。结论 该研究发现 COVID - 19 患者脾肿大与 LI 之间存在轻微的、统计学上无显著意义的相关性,这表明虽然脾脏肿大可能反映全身疾病受累,但它并不是肺损伤程度的强有力独立预测指标。这些发现凸显了肺外表现的复杂性,并强调需要进一步研究以充分了解脾脏受累在 COVID - 19 中的意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44e3/10985569/31b1e77aed8a/cureus-0016-00000055415-i01.jpg

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