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2019年冠状病毒病疫情对既往因创伤性臂丛神经麻痹接受膈神经移位术患者的影响。

Effects of COVID-19 Pandemic in Patients with a Previous Phrenic Nerve Transfer for a Traumatic Brachial Plexus Palsy.

作者信息

Socolovsky Mariano, Lu Johnny Chuieng-Yi, Zarra Francisco, Wei Chen Kuan, Chang Tommy Nai-Jen, Chuang David Chwei-Chin

机构信息

Division of Neurosurgery, Hospital de Clínicas, University of Buenos Aires School of Medicine, Buenos Aires, Argentina.

Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.

出版信息

J Brachial Plex Peripher Nerve Inj. 2024 Jun 12;19(1):e20-e26. doi: 10.1055/s-0044-1787296. eCollection 2024 Jan.

Abstract

With the advent of the coronavirus disease 2019 (COVID-19) pandemic, some doubts have been raised regarding the potential respiratory problems that patients who previously underwent a phrenic nerve transfer could have.  To analyze the effects of the coronavirus infection on two populations, one from Argentina and another from Taiwan. Specific objectives were: (1) to identify the rate of COVID in patients with a history of phrenic nerve transfer for treatment of palsy; (2) to identify the overall symptom profile; (3) to compare Argentinian versus Taiwanese populations; and (4) to determine if any phrenic nerve transfer patients are at particular risk of more severe COVID.  A telephonic survey that included data regarding the number of episodes of acute COVID-19 infection, the symptoms it caused, the presence or absence of potential or life-threatening complications, and the status of COVID-19 vaccination were studied. Intergroup comparisons were conducted using the nonparametric Mann-Whitney U test, with categorical variables conducted using either the Pearson χ2 analysis or the Fisher's exact test, as appropriate.  A total of 77 patients completed the survey, 40 from Taiwan and 37 from Argentina. Fifty-five (71.4%) developed a diagnosis of COVID. However, among these, only four had any level of dyspnea reported (4/55 = 7.3%), all mild. There were also no admissions to hospital or an intensive care unit, no intubations, and no deaths. All 55 patients isolated themselves at home.  It can be concluded that an acute COVID-19 infection was very well tolerated in our patients. (Level of evidence 3b, case reports).

摘要

随着2019冠状病毒病(COVID-19)大流行的出现,对于先前接受膈神经移位术的患者可能出现的潜在呼吸问题产生了一些疑问。

为了分析冠状病毒感染对两组人群的影响,一组来自阿根廷,另一组来自台湾。具体目标如下:(1)确定有膈神经移位术治疗麻痹病史的患者中COVID的发生率;(2)确定总体症状特征;(3)比较阿根廷与台湾人群;(4)确定是否有任何膈神经移位术患者有患更严重COVID的特殊风险。

对一项电话调查进行了研究,该调查包括有关急性COVID-19感染发作次数、其引起的症状、是否存在潜在或危及生命的并发症以及COVID-19疫苗接种状况的数据。组间比较采用非参数曼-惠特尼U检验,分类变量根据情况采用Pearson χ2分析或Fisher精确检验。

共有77名患者完成了调查,40名来自台湾,37名来自阿根廷。55名(71.4%)被诊断为COVID。然而,其中只有4人报告有任何程度的呼吸困难(4/55 = 7.3%),均为轻度。也没有住院或入住重症监护病房的情况,没有插管,也没有死亡。所有55名患者都在家中自我隔离。

可以得出结论,我们的患者对急性COVID-19感染耐受性良好。(证据级别3b,病例报告)

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