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[新型冠状病毒肺炎康复后长期肺损伤的临床及形态学特征]

[Clinical and morphological features of lung injury long-term after SARS-CoV-2 recovery].

作者信息

Baimakanova G E, Samsonova M, Chernyaev A L, Kontorschikov A S, Belevskiy A S

机构信息

Loginov Moscow Clinical Scientific Center.

Research Institute of Pulmonology.

出版信息

Ter Arkh. 2024 Apr 16;96(3):218-227. doi: 10.26442/00403660.2024.03.202647.

DOI:10.26442/00403660.2024.03.202647
PMID:38713035
Abstract

AIM

To study the clinical and histological profile of lung tissue in patients with persistent pulmonary disease, respiratory symptoms and CT findings after SARS-CoV-2 infection.

MATERIALS AND METHODS

The study included 15 patients (7 females and 8 males) with a mean age of 57.7 years. All patients underwent laboratory tests, chest computed tomography, echocardiography, and pulmonary function tests. Pulmonary tissue and bronchoalveolar lavage samples were obtained by fibrobronchoscopy, transbronchial forceps (2 patients), and lung cryobiopsy (11 patients); open biopsy was performed in 2 patients. Cellular composition, herpesvirus DNA, SARS-CoV-2, complex, galactomannan optical density index, and bacterial and fungal microflora growth were determined in bronchoalveolar lavage. SARS-CoV-2 was also identified in samples from the nasal mucosa, throat and feces using a polymerase chain reaction.

RESULTS

The results showed no true pulmonary fibrosis in patients recovered from SARS-CoV-2 infection with persistent respiratory symptoms, functional impairment, and CT findings after SARS-CoV-2 infection. The observed changes comply with the current and/or resolving infection and inflammatory process.

CONCLUSION

Thus, no true pulmonary fibrosis was found in patients after SARS-CoV-2 infection with persistent respiratory symptoms, functional impairment, and CT findings. The observed changes comply with the current and/or resolving infection and inflammatory process.

摘要

目的

研究新型冠状病毒2感染后出现持续性肺部疾病、呼吸道症状及CT表现的患者肺组织的临床和组织学特征。

材料与方法

该研究纳入了15例患者(7例女性和8例男性),平均年龄57.7岁。所有患者均接受了实验室检查、胸部计算机断层扫描、超声心动图和肺功能测试。通过纤维支气管镜检查、经支气管活检钳(2例患者)和肺冷冻活检(11例患者)获取肺组织和支气管肺泡灌洗样本;2例患者进行了开放活检。测定支气管肺泡灌洗中的细胞成分、疱疹病毒DNA、新型冠状病毒2复合物、半乳甘露聚糖光密度指数以及细菌和真菌微生物群生长情况。还使用聚合酶链反应在鼻黏膜、咽喉和粪便样本中鉴定新型冠状病毒2。

结果

结果显示,新型冠状病毒2感染康复后出现持续性呼吸道症状、功能障碍及CT表现的患者未出现真正的肺纤维化。观察到的变化符合当前和/或正在消退的感染及炎症过程。

结论

因此,新型冠状病毒2感染后出现持续性呼吸道症状、功能障碍及CT表现的患者未发现真正的肺纤维化。观察到的变化符合当前和/或正在消退的感染及炎症过程。

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