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长新冠的见解:剖析风险因素、临床特征、影像学表现、功能后遗症及相关性:一项回顾性队列研究

Insights into Long COVID: Unraveling Risk Factors, Clinical Features, Radiological Findings, Functional Sequelae and Correlations: A Retrospective Cohort Study.

作者信息

Pasculli Patrizia, Zingaropoli Maria Antonella, Dominelli Federica, Solimini Angelo Giuseppe, Masci Giorgio Maria, Birtolo Lucia Ilaria, Pasquariello Lara, Paribeni Filippo, Iafrate Franco, Panebianco Valeria, Galardo Gioacchino, Mancone Massimo, Catalano Carlo, Pugliese Francesco, Palange Paolo, Mastroianni Claudio Maria, Ciardi Maria Rosa

机构信息

Department of Public Health and Infectious Diseases, Rome, Italy.

Department of Public Health and Infectious Diseases, Rome, Italy.

出版信息

Am J Med. 2025 Apr;138(4):721-731. doi: 10.1016/j.amjmed.2024.09.006. Epub 2024 Sep 18.

Abstract

BACKGROUND

The long-term symptomatology of COVID-19 has yet to be comprehensively described. The aim of the study was to describe persistent COVID-19 symptoms in a cohort of hospitalized and home-isolated patients.

METHODS

A retrospective cohort study was conducted on long COVID patients. Long COVID symptoms were identified, and patients were divided into hospitalized (in-patients) and home-isolated (out-patients), as well as according to the number of symptoms. Patients were examined by a multidisciplinary medical team. Blood tests, high resolution chest computed tomography (CT), and physical and infectious examinations were performed. Finally, in-patients were evaluated at 2 time-points: on hospital admission (T0) and 3 months after discharge (Tpost).

RESULTS

There were 364 COVID-19 patients enrolled; 82% of patients reported one or more symptoms. The most reported symptom was fatigue. Chest CT showed alteration in 76% of patients, and pulmonary function alterations were observed in 44.7% of patients. A higher risk of presenting at least one symptom was seen in patients treated with corticosteroid, and a higher risk of presenting chest CT residual lesion was observed in hospitalized patients and in patients that received hydroxychloroquine treatment. Moreover, a higher risk of altered pulmonary function was observed in older patients.

CONCLUSION

Long-term sequelae are present in a remarkable number of long COVID patients and pose a new challenge to the health care system to identify long-lasting effects and improve patients' well-being. Multidisciplinary teams are crucial to develop preventive measures, and clinical management strategies.

摘要

背景

新冠病毒病(COVID-19)的长期症状尚未得到全面描述。本研究的目的是描述一组住院和居家隔离患者中持续存在的COVID-19症状。

方法

对新冠后综合征患者进行了一项回顾性队列研究。确定了新冠后综合征症状,并将患者分为住院患者(住院)和居家隔离患者(门诊),同时根据症状数量进行划分。由多学科医疗团队对患者进行检查。进行了血液检查、高分辨率胸部计算机断层扫描(CT)以及体格和感染方面的检查。最后,对住院患者在两个时间点进行评估:入院时(T0)和出院后3个月(Tpost)。

结果

共纳入364例COVID-19患者;82%的患者报告有一个或多个症状。最常报告的症状是疲劳。胸部CT显示76%的患者有改变,44.7%的患者观察到肺功能改变。接受皮质类固醇治疗的患者出现至少一种症状的风险更高,住院患者以及接受羟氯喹治疗的患者出现胸部CT残留病变的风险更高。此外,老年患者肺功能改变的风险更高。

结论

相当数量的新冠后综合征患者存在长期后遗症,这给医疗保健系统带来了新的挑战,即识别长期影响并改善患者的健康状况。多学科团队对于制定预防措施和临床管理策略至关重要。

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