Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, China.
Department of Pulmonary and Critical Care Medicine, Fujian Provincial Hospital, Fuzhou, 350001, China.
Sci Rep. 2024 Nov 26;14(1):29257. doi: 10.1038/s41598-024-79715-2.
Documented radiological and physiological anomalies among coronavirus disease 2019 survivors necessitate prompt recognition of residual pulmonary parenchymal abnormalities for effective management of chronic pulmonary consequences. This study aimed to devise a predictive model to identify patients at risk of such abnormalities post-COVID-19. Our prognostic model was derived from a dual-center retrospective cohort comprising 501 hospitalized COVID-19 cases from July 2022 to March 2023. Of these, 240 patients underwent Chest CT scans three months post-infection. A predictive model was developed using stepwise regression based on the Akaike Information Criterion, incorporating clinical and laboratory parameters. The model was trained and validated on a split dataset, revealing a 33.3% incidence of pulmonary abnormalities. It achieved strong discriminatory power in the training set (area under the curve: 0.885, 95% confidence interval 0.832-0.938), with excellent calibration and decision curve analysis suggesting substantial net benefits across various threshold settings. We have successfully developed a reliable prognostic tool, complemented by a user-friendly nomogram, to estimate the probability of residual pulmonary parenchymal abnormalities three months post-COVID-19 infection. This model, demonstrating high performance, holds promise for guiding clinical interventions and improving the management of COVID-19-related pulmonary sequela.
在 2019 冠状病毒病幸存者中,有记录的放射学和生理学异常需要及时识别肺部实质残留异常,以有效管理慢性肺部后果。本研究旨在制定一种预测模型,以识别 COVID-19 后有此类异常风险的患者。我们的预后模型来自 2022 年 7 月至 2023 年 3 月期间在两个中心进行的回顾性队列研究,共纳入 501 例住院 COVID-19 病例,其中 240 例在感染后三个月接受了胸部 CT 扫描。该模型是基于 Akaike 信息准则的逐步回归法,结合临床和实验室参数而建立的。该模型在数据集分割上进行了训练和验证,结果显示 33.3%的患者存在肺部异常。在训练集上,该模型具有很强的判别能力(曲线下面积:0.885,95%置信区间 0.832-0.938),校准度和决策曲线分析均表现良好,提示在各种阈值设置下具有显著的净获益。我们成功开发了一种可靠的预后工具,并附有用户友好的列线图,用于估计 COVID-19 感染后三个月肺部实质残留异常的概率。该模型表现出较高的性能,有望为指导临床干预和改善 COVID-19 相关肺部后遗症的管理提供帮助。