The University of Texas Southwestern Medical Center, United States.
The University of Texas Southwestern Medical Center, United States.
Heart Lung. 2024 Sep-Oct;67:137-143. doi: 10.1016/j.hrtlng.2024.05.004. Epub 2024 May 16.
COVID patients continue to experience unremitting symptoms that extend far beyond the initial illness. While there is rapid accumulation of data on acute COVID treatment in hospitalized patients, little is known regarding post-COVID management.
To describe our center's experience treating post-COVID sub-syndromes encountered in Post-COVID Lung Clinic.
We retrospectively reviewed data on 98 post-COVID patients evaluated in our clinic between 07/01/2020-12/31/2022. We encountered three distinct post-COVID subtypes: 1) respiratory complaints associated with increased O2 requirements and abnormal CT findings (post-COVID interstitial lung disease [ILD]), 2) respiratory complaints associated with tachycardia (post-COVID dyspnea-tachycardia syndrome [DTS]). Post-COVID ILD patients (n = 28) received steroids in combination with cell cycle inhibitor (mycophenolate mofetil-MMF). Post-COVID DTS patients (n = 16) were treated with metoprolol. 3) A third, undifferentiated group presented with mild respiratory complaints and normal spirometry (n = 17) and was followed in clinic without initiation of a specific treatment.
In treated post-COVID ILD patients, mean oxygen requirements at rest (1.96 ± 1.79 L/NC) decreased to 0.89 ± 1.29 L/NC at 6 months follow-up, p = 0.005. In patients with post-COVID DTS, mean heart rate at rest decreased (98 ± 15 bpm to 79 ± 11 bpm) at 6 months follow-up, p = 0.023. 60 % of patients reported an improvement in exertional dyspnea.
Our descriptive study presents a single center outpatient COVID-19 clinic experience. We encountered 3 post-COVID sub-syndromes and describe their treatments: post-COVID interstitial lung disease [ILD] treated with a novel regimen of MMF and steroids, post COVID dyspnea-tachycardia syndrome [DTS] treated with metoprolol, and a third subgroup with mild undifferentiated symptoms without specific treatment.
COVID 患者持续出现持久症状，这些症状远远超出了初始疾病的范围。虽然关于住院患者急性 COVID 治疗的数据迅速积累，但对于 COVID 后管理知之甚少。
描述我们中心在 COVID 后肺诊所治疗 COVID 后亚综合征的经验。
我们回顾性分析了 2020 年 7 月 1 日至 2022 年 12 月 31 日期间在我们诊所接受评估的 98 例 COVID 后患者的数据。我们遇到了三种不同的 COVID 后亚型：1）与增加的 O2 需求和异常 CT 发现相关的呼吸投诉（COVID 后间质性肺病 [ILD]），2）与心动过速相关的呼吸投诉（COVID 后呼吸困难心动过速综合征 [DTS]）。COVID 后 ILD 患者（n = 28）接受了类固醇联合细胞周期抑制剂（霉酚酸酯-MMF）治疗。COVID 后 DTS 患者（n = 16）接受了美托洛尔治疗。3）第三组，未分化组表现为轻度呼吸投诉和正常肺量计（n = 17），并在诊所随访，而不启动特定治疗。
在接受治疗的 COVID 后 ILD 患者中，静息时平均氧气需求（1.96 ± 1.79 L/NC）在 6 个月随访时降至 0.89 ± 1.29 L/NC，p = 0.005。在 COVID 后 DTS 患者中，静息时平均心率（98 ± 15 bpm 降至 79 ± 11 bpm）在 6 个月随访时下降，p = 0.023。60%的患者报告呼吸困难在运动时得到改善。
我们的描述性研究介绍了一个单中心门诊 COVID-19 诊所的经验。我们遇到了 3 种 COVID 后亚综合征，并描述了它们的治疗方法：用 MMF 和类固醇的新方案治疗 COVID 后间质性肺病 [ILD]，用美托洛尔治疗 COVID 后呼吸困难心动过速综合征 [DTS]，以及第三个亚组为轻度未分化症状，无特定治疗。
