Wu Linxia, Han Xiaoyu, Chen Lu, Guo Liyan, Li Yumin, Alwalid Osamah, Nie Tong, Wu Feihong, Zhi Xiaoling, Fan Yanqing, Shi Heshui, Zheng Chuansheng
Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, Hubei Province 430022, The People's Republic of China (L.W., X.H., Y.L., T.N., F.W., X.Z., H.S., C.Z.); Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, The People's Republic of China (L.W., X.H., Y.L., T.N., F.W., X.Z., H.S., C.Z.).
Department of Radiology, Wuhan Jinyintan Hospital, Tongji Medical College of HuaZhong University of Science and Technology, 430023, The People's Republic of China (L.C., Y.F.).
Acad Radiol. 2025 Jan;32(1):471-481. doi: 10.1016/j.acra.2024.07.016. Epub 2024 Jul 27.
Little is known about the long-term impact of diabetes on lung impairment in COVID-19 survivors over a three-year period. This study evaluated the long-term impact of diabetes on persistent radiological pulmonary abnormalities and lung function impairment in COVID-19 survivors over three years.
In this prospective, multicenter, cohort study, pulmonary sequelae were compared between COVID-19 survivors with and without diabetes. Serial chest CT scans, symptom questionnaires and pulmonary function tests were obtained 6 months, 12 months, 2 years and 3 years post-discharge. The independent predictors for lung dysfunction at the 3-year follow-up were analyzed.
A total of 278 COVID-19 survivors (63 [IQR 57-69] year-old, female: 103 [37.0%]) were included. At the 3-year follow-up, individuals in the diabetes group had higher incidences of respiratory symptoms, radiological pulmonary abnormalities and pulmonary diffusion dysfunction than those in the control group. Diabetes (OR: 2.18, 95% CI: 1.04-4.59, p = 0.034), allergy (OR: 2.26, 95% CI: 1.09-4.74, p = 0.029), female (OR: 2.70, 95% CI: 1.37-5.29, p = 0.004), severe COVID-19 (OR: 4.10, 95% CI: 1.54-10.93, p = 0.005), and fibrotic-like CT changes (OR: 5.64, 95% CI: 2.28-13.98, p < 0.001) were independent predictors of pulmonary diffusion dysfunction in COVID-19 survivors.
These results highlight the long-term deleterious effect of diabetes status on radiological pulmonary abnormalities and pulmonary dysfunction in COVID-19 survivors. This study provides important evidence support for long-term monitoring of lung abnormalities in COVID-19 recovery survivors with diabetes.
关于糖尿病对新冠病毒病（COVID-19）幸存者三年期间肺部损伤的长期影响，人们了解甚少。本研究评估了糖尿病对COVID-19幸存者三年期间持续性肺部影像学异常和肺功能损害的长期影响。
在这项前瞻性、多中心队列研究中，对有糖尿病和无糖尿病的COVID-19幸存者的肺部后遗症进行了比较。在出院后6个月、12个月、2年和3年进行系列胸部CT扫描、症状问卷调查和肺功能测试。分析了3年随访时肺功能障碍的独立预测因素。
共纳入278例COVID-19幸存者（年龄63[四分位间距57 - 69]岁，女性103例[37.0%]）。在3年随访时，糖尿病组个体的呼吸道症状、肺部影像学异常和肺弥散功能障碍的发生率高于对照组。糖尿病（比值比：2.18，95%置信区间：1.04 - 4.59，p = 0.034）、过敏（比值比：2.26，95%置信区间：1.09 - 4.74，p = 0.029）、女性（比值比：2.70，95%置信区间：1.37 - 5.29，p = 0.004）、重症COVID-19（比值比：4.10，95%置信区间：1.54 - 10.93，p = 0.005）和纤维化样CT改变（比值比：5.64，95%置信区间：2.28 - 13.98，p < 0.001）是COVID-19幸存者肺弥散功能障碍的独立预测因素。
这些结果突出了糖尿病状态对COVID-19幸存者肺部影像学异常和肺功能障碍的长期有害影响。本研究为对患有糖尿病的COVID-19康复幸存者的肺部异常进行长期监测提供了重要的证据支持。
