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[严重冠状病毒病 19 幸存者肺功能受损的因素]

[Factors for spirometric impairment in survivors of severe coronavirus-19 disease].

作者信息

Che-Morales José Luis, Sánchez-Cruz Juan Francisco, Moo-Puc Rosa Esther

机构信息

Instituto Mexicano del Seguro Social, Unidad Médica de Atención Ambulatoria 01, Departamento de Neumología e Inhaloterapia. Mérida, Yucatán, México.

Instituto Mexicano del Seguro Social, Órgano de Operación Administrativa Desconcentrada Estatal Yucatán, Departamento de Enseñanza Delegacional. Mérida, Yucatán, México.

出版信息

Rev Med Inst Mex Seguro Soc. 2024 Sep 2;62(5):1-7. doi: 10.5281/zenodo.12668030.

Abstract

BACKGROUND

Patients with severe coronavirus-19 disease (COVID-19) have more spirometric alterations, especially a restrictive pattern characterized by low forced vital capacity (FVC). Some variables associated with this alteration in lung function have been described, such as hypoxemia, vaccination and hand strength, which in turn are related to the magnitude of lung damage.

OBJECTIVE

To analyze different clinical variables and their association with alterations in spirometry in survivors of severe COVID-19.

MATERIAL AND METHODS

Retrospective and observational study of survivors of severe COVID-19 sent for their first spirometry, hand dynamometry, and 6-minute walk (6MW) in a secondary care unit during 2021.

RESULTS

2 doses of SARS-CoV-2 vaccine were protective factor (odds ratio [OR]: 0.36, 95% CI [95% CI]: 0.1-0.8, p = 0.02) and hospitalization (> 15 days) was a risk factor for spirometric alterations (FVC < 80% of predicted) (OR: 3.0; 95% CI 1.3-6.8, p = 0.00); hand weakness, SpO2 desaturation > 4% in 6MW, and days of hospitalization were associated with low FVC.

CONCLUSIONS

A hospitalization > 15 days and having 2 doses of vaccination are risk and protective factors, respectively, of having a low FVC. Days of hospitalization, vaccination status, and FVC allowed to identify clusters of severe COVID-19 survivors with greater deterioration.

摘要

背景

患有重症冠状病毒病19(COVID-19)的患者有更多的肺量计改变,尤其是以低用力肺活量(FVC)为特征的限制性模式。已经描述了一些与这种肺功能改变相关的变量,如低氧血症、疫苗接种和握力,而这些又与肺损伤的程度有关。

目的

分析重症COVID-19幸存者的不同临床变量及其与肺量计改变的关联。

材料与方法

对2021年在二级护理单位接受首次肺量计检查、握力测量和6分钟步行试验(6MW)的重症COVID-19幸存者进行回顾性观察研究。

结果

2剂严重急性呼吸综合征冠状病毒2(SARS-CoV-2)疫苗是保护因素(优势比[OR]:0.36,95%置信区间[95%CI]:0.1 - 0.8,p = 0.02),住院时间超过15天是肺量计改变(FVC < 预测值的80%)的危险因素(OR:3.0;95%CI 1.3 - 6.8,p = 0.00);握力减弱、6MW期间血氧饱和度下降>4%以及住院天数与低FVC相关。

结论

住院时间超过15天和接种2剂疫苗分别是FVC降低的危险因素和保护因素。住院天数、疫苗接种状态和FVC有助于识别病情恶化更严重的重症COVID-19幸存者群体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d232/12413203/f28c976c71e4/04435117-62-5-e6156-c001.jpg

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