Fernández-Trujillo Liliana, Galindo-Sánchez Juan Sebastián, Cediel Angie, García Carlos A, Morales Eliana I, Largo Jessica, Amezquita-Dussan María A
Department of Internal Medicine, Pulmonology Service, Fundación Valle del Lili, Cali, Colombia.
Faculty of Health Sciences, Universidad Icesi, Cali, Colombia.
SAGE Open Med. 2024 Sep 9;12:20503121241275369. doi: 10.1177/20503121241275369. eCollection 2024.
Severe COVID-19 can result in long-term sequelae known as "chronic COVID," characterized by a wide range of persistent physical and mental symptoms. Chest imaging and pulmonary function test alterations have been observed in recovered patients. Most studies focus on up to a 3-month follow-up after symptom onset or hospital discharge, with few reports on long-term follow-up and limited evidence regarding disease progression in Latin America.
This study aims to describe the clinical characteristics and changes in pulmonary function, imaging, and quality of life in severe and critical COVID-19 patients requiring ICU admission in a high-complexity hospital in Latin America. A prospective cohort of survivors underwent clinical, radiological, pulmonary function, and quality of life assessments 6 and 12 months post-discharge.
One hundred twelve patients were included, all of whom attended the 6-month follow-up, and 99 returned for the 12-month follow-up. Most subjects had no previous respiratory symptoms or significant medical history. At the end of the follow-up period, 74% of the patients showed interstitial infiltrates in chest tomography and a higher frequency of fibroatelectatic tracts and parenchymal bands. Pulmonary function tests returned to normal ranges, except for carbon monoxide diffusion, but no altered scores were reported in the questionnaires.
Despite residual radiological findings, most parameters studied in severe and critical COVID-19 survivors improved over the 12-month follow-up period. Regardless of the imaging abnormalities, the improvement in variables such as symptomatic relief and normal pulmonary function suggests that these alterations are transient. Carbon monoxide diffusion did not normalize by the end of the follow-up, which is consistent with the abnormalities reported in multiple studies, indicating a potential disease-related pattern.
重症新型冠状病毒肺炎（COVID-19）可导致称为“慢性COVID”的长期后遗症，其特征为广泛的持续身心症状。康复患者中已观察到胸部影像学和肺功能测试改变。大多数研究聚焦于症状出现或出院后长达3个月的随访，拉丁美洲关于长期随访及疾病进展的证据有限，相关报告较少。
本研究旨在描述拉丁美洲一家高复杂性医院中需要入住重症监护病房（ICU）的重症及危重症COVID-19患者的临床特征、肺功能、影像学及生活质量变化。一组幸存者前瞻性队列在出院后6个月和12个月接受了临床、放射学、肺功能及生活质量评估。
纳入112例患者，所有患者均参加了6个月随访，99例返回参加12个月随访。大多数受试者既往无呼吸系统症状或重大病史。随访期末，74%的患者胸部断层扫描显示间质浸润，纤维性肺不张区域和实质条索出现频率更高。除一氧化碳弥散外，肺功能测试恢复至正常范围，但问卷中未报告得分改变。
尽管存在残留的影像学表现，但在12个月的随访期内，重症及危重症COVID-19幸存者的大多数研究参数有所改善。无论影像学异常情况如何，症状缓解和肺功能正常等变量的改善表明这些改变是暂时的。随访结束时一氧化碳弥散未恢复正常，这与多项研究报告的异常情况一致，表明存在潜在的疾病相关模式。
