Servicio de Neumología, Hospital Universitario Son Espases, 07120 Palma de Mallorca, Spain.
Institut d'Investigació Sanitària Illes Balears (IdISBa), 07120 Palma de Mallorca, Spain.
Int J Mol Sci. 2024 Jul 2;25(13):7270. doi: 10.3390/ijms25137270.
Although pulmonary embolism (PE) is a frequent complication in COVID-19, its consequences remain unknown. We performed pulmonary function tests, echocardiography and computed tomography pulmonary angiography and identified blood biomarkers in a cohort of consecutive hospitalized COVID-19 patients with pneumonia to describe and compare medium-term outcomes according to the presence of PE, as well as to explore their potential predictors. A total of 141 patients (56 with PE) were followed up during a median of 6 months. Post-COVID-19 radiological lung abnormalities (PCRLA) and impaired diffusing capacity for carbon monoxide (DLCOc) were found in 55.2% and 67.6% cases, respectively. A total of 7.3% had PE, and 6.7% presented an intermediate-high probability of pulmonary hypertension. No significant difference was found between PE and non-PE patients. Univariate analysis showed that age > 65, some clinical severity factors, surfactant protein-D, baseline C-reactive protein, and both peak red cell distribution width and Interleukin (IL)-10 were associated with DLCOc < 80%. A score for PCRLA prediction including age > 65, minimum lymphocyte count, and IL-1β concentration on admission was constructed with excellent overall performance. In conclusion, reduced DLCOc and PCRLA were common in COVID-19 patients after hospital discharge, but PE did not increase the risk. A PCRLA predictive score was developed, which needs further validation.
虽然肺栓塞(PE)是 COVID-19 的常见并发症,但它的后果仍不清楚。我们对连续住院的 COVID-19 肺炎患者进行了肺功能检查、超声心动图和计算机断层扫描肺动脉造影,并鉴定了血液生物标志物,以描述和比较根据是否存在 PE 的中期结果,并探讨其潜在的预测因素。共 141 例患者(56 例有 PE)在中位 6 个月内接受了随访。在 55.2%和 67.6%的病例中分别发现了 COVID-19 后放射性肺异常(PCRLA)和一氧化碳弥散量(DLCOc)受损。总的来说,有 7.3%的患者存在 PE,6.7%的患者有中高度肺动脉高压的可能性。PE 患者和非 PE 患者之间没有显著差异。单因素分析显示,年龄 > 65 岁、某些临床严重程度因素、表面活性剂蛋白-D、基线 C 反应蛋白、红细胞分布宽度和白细胞介素(IL)-10 的峰值均与 DLCOc < 80%相关。构建了一个包括年龄 > 65 岁、最低淋巴细胞计数和入院时 IL-1β浓度的 PCRLA 预测评分,总体性能良好。总之,COVID-19 患者出院后,DLCOc 和 PCRLA 降低较为常见,但 PE 不会增加风险。构建了一个 PCRLA 预测评分,需要进一步验证。