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轻度新型冠状病毒肺炎对中期呼吸功能的影响。

The impact of mild COVID-19 on medium-term respiratory function.

作者信息

van Heerden J, Strijdom H, Parker A, Allwood B W, Lalla U, Lombard C J, Koegelenberg C F N

机构信息

Division of Pulmonology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa.

Centre for Cardiometabolic Research in Africa, Division of Medical Physiology, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

出版信息

Afr J Thorac Crit Care Med. 2024 Oct 14;30(3):e1629. doi: 10.7196/AJTCCM.2024.v30i3.1629. eCollection 2024.

Abstract

BACKGROUND

There is a paucity of evidence on the impact of mild COVID-19 on the respiratory system, particularly in non-healthcare seeking individuals.

OBJECTIVES

To investigate the effects of mild COVID-19 on respiratory function and to identify indicators of decreased lung function.

METHODS

We conducted a cross-sectional study in 175 non-healthcare-seeking individuals with confirmed acute SARS-CoV-2 infection who did not require hospitalisation. Participants were divided into three groups: those who had pulmonary function tests (PFTs) within 6 months, between 6 and 12 months, and between 12 and 24 months after infection. Each participant underwent spirometry, measurement of the diffusing capacity of the lungs for carbon monoxide (DL ), a 6-minute walking distance test (6MWD) and plethysmography.

RESULTS

The mean age of the participants was 44.3 years, and the mean body mass index (BMI) 32.7 kg/m². Forty-six participants had PFTs within 6 months, 64 between 6 and 12 months, and 65 between 12 and 24 months. Lower than expected DL was the most commonly detected abnormality (57%). Spirometry anomalies were noted in 23%, 10% showing an obstructive impairment and 13% a restrictive impairment, confirmed by a total lung capacity <80%. An increased BMI was the only variable that was significantly and independently linearly associated with lower than predicted (<80%) forced vital capacity, forced expiratory volume in the 1st second, DL and 6MWD.

CONCLUSION

DL was low in a considerable proportion of non-healthcare-seeking individuals 2 years after mild COVID-19. A high BMI was found to be significantly and independently associated with lower than predicted PFT results and 6MWD.

STUDY SYNOPSIS

We found that pulmonary function, particularly diffusing capacity, was lower than predicted in a significant proportion of non-healthcare-seeking individuals up to 2 years after mild COVID-19. A high body mass index (BMI) was found to be significantly and independently associated with decreased lung function. There is a paucity of evidence on the medium-term effects of mild COVID-19 on the respiratory system in non-healthcare-seeking individuals. We investigated the medium-term effects of mild COVID-19 on the respiratory system, showed lower than predicted lung function, and identified one independent predictor, BMI. Even individuals classified as having 'mild' COVID-19 could have medium-term respiratory sequelae.

摘要

背景

关于轻度新型冠状病毒肺炎(COVID-19)对呼吸系统的影响,证据较少,尤其是在未寻求医疗服务的个体中。

目的

研究轻度COVID-19对呼吸功能的影响,并确定肺功能下降的指标。

方法

我们对175例确诊为急性严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染且无需住院的未寻求医疗服务的个体进行了一项横断面研究。参与者被分为三组:感染后6个月内、6至12个月之间以及12至24个月之间进行肺功能测试(PFT)的个体。每位参与者均接受了肺活量测定、肺一氧化碳弥散量(DL)测量、6分钟步行距离测试(6MWD)和体积描记法。

结果

参与者的平均年龄为44.3岁,平均体重指数(BMI)为32.7kg/m²。46例参与者在6个月内进行了PFT,64例在6至12个月之间进行了PFT,65例在12至24个月之间进行了PFT。低于预期的DL是最常检测到的异常(57%)。肺活量测定异常在23%的参与者中被发现,10%表现为阻塞性损害,13%表现为限制性损害,通过总肺活量<80%得以证实。BMI增加是唯一与低于预测值(<80%)的用力肺活量、第1秒用力呼气量、DL和6MWD显著且独立线性相关的变量。

结论

轻度COVID-19感染2年后,相当一部分未寻求医疗服务的个体DL较低。发现高BMI与低于预测值的PFT结果和6MWD显著且独立相关。

研究总结

我们发现,在轻度COVID-19感染后的2年里,相当一部分未寻求医疗服务的个体的肺功能,尤其是弥散能力,低于预期。发现高体重指数(BMI)与肺功能下降显著且独立相关。关于轻度COVID-19对未寻求医疗服务个体呼吸系统的中期影响,证据较少。我们研究了轻度COVID-19对呼吸系统的中期影响,发现肺功能低于预期,并确定了一个独立预测因素BMI。即使被归类为患有“轻度”COVID-19的个体也可能有中期呼吸后遗症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4394/11633238/7c548b74d8e7/AJTCCM-30-3-1629-fig1.jpg

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