COVID-19 的放射学、功能和血清学后果在 6 个月和 18 个月随访时的前瞻性队列研究。
COVID-19's Radiologic, Functional, and Serologic Consequences at 6-Month and 18-Month Follow-up: A Prospective Cohort Study.
机构信息
Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea.
Division of Infectious Diseases, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea.
出版信息
J Korean Med Sci. 2024 Aug 19;39(32):e228. doi: 10.3346/jkms.2024.39.e228.
BACKGROUND
We evaluated the radiologic, pulmonary functional, and antibody statuses of coronavirus disease 2019 (COVID-19) patients 6 and 18 months after discharge, comparing changes in status and focusing on risk factors for residual computed tomography (CT) abnormalities.
METHODS
This prospective cohort study was conducted on COVID-19 patients discharged between April 2020 and January 2021. Chest CT, pulmonary function testing (PFT), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin G (IgG) measurements were performed 6 and 18 months after discharge. We evaluated factors associated with residual CT abnormalities and the correlation between lesion volume in CT (lesion), PFT, and IgG levels.
RESULTS
This study included 68 and 42 participants evaluated 6 and 18 months, respectively, after hospitalizations for COVID-19. CT abnormalities were noted in 22 participants (32.4%) at 6 months and 13 participants (31.0%) at 18 months. Lesion was significantly lower at 18 months than 6 months ( < 0.001). Patients with CT abnormalities at 6 months showed lower forced expiratory volume in 1 second (FEV1) and FEV1/forced vital capacity (FVC), and patients with CT abnormalities at 18 months exhibited lower FVC. FVC significantly improved between 6 and 18 months of follow-up (all < 0.0001). SARS-CoV-2 IgG levels were significantly higher in patients with CT abnormalities at 6 and 18 months ( < 0.001). At 18-month follow-up assessments, age was associated with CT abnormalities (odds ratio, 1.17; 95% confidence interval, 1.03-1.32; = 0.01), and lesion showed a positive correlation with IgG level ( = 0.643, < 0.001).
CONCLUSION
At 18-month follow-up assessments, 31.0% of participants exhibited residual CT abnormalities. Age and higher SARS-CoV-2 IgG levels were significant predictors, and FVC was related to abnormal CT findings at 18 months. Lesion and FVC improved between 6 and 18 months.
TRIAL REGISTRATION
Clinical Research Information Service Identifier: KCT0008573.
背景
我们评估了 2019 年冠状病毒病（COVID-19）患者出院后 6 个月和 18 个月的影像学、肺功能和抗体状况，比较了状态变化，并重点关注残留计算机断层扫描（CT）异常的危险因素。
方法
这是一项前瞻性队列研究，纳入了 2020 年 4 月至 2021 年 1 月期间出院的 COVID-19 患者。在出院后 6 个月和 18 个月时进行了胸部 CT、肺功能检测（PFT）和严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）免疫球蛋白 G（IgG）测量。我们评估了与残留 CT 异常相关的因素，以及 CT 病变（lesion）、PFT 和 IgG 水平之间的相关性。
结果
这项研究共纳入了 68 名和 42 名参与者，分别在 COVID-19 住院后 6 个月和 18 个月进行了评估。22 名（32.4%）参与者在 6 个月时出现 CT 异常，13 名（31.0%）参与者在 18 个月时出现 CT 异常。18 个月时的病变明显低于 6 个月（ < 0.001）。6 个月时有 CT 异常的患者用力呼气量 1 秒（FEV1）和 FEV1/用力肺活量（FVC）较低，18 个月时有 CT 异常的患者 FVC 较低。FVC 在 6 至 18 个月的随访中显著改善（均 < 0.0001）。6 个月和 18 个月时有 CT 异常的患者 SARS-CoV-2 IgG 水平均显著升高（均 < 0.001）。在 18 个月的随访评估中，年龄与 CT 异常相关（比值比，1.17；95%置信区间，1.03-1.32； = 0.01），病变与 IgG 水平呈正相关（ = 0.643， < 0.001）。
结论
在 18 个月的随访评估中，31.0%的参与者存在残留 CT 异常。年龄和较高的 SARS-CoV-2 IgG 水平是显著的预测因素，而 FVC 与 18 个月时的异常 CT 结果有关。病变和 FVC 在 6 至 18 个月之间改善。
试验注册
临床研究信息服务标识符：KCT0008573。
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