Lazar Mihai, Barbu Ecaterina Constanta, Chitu Cristina Emilia, Buzoianu Mihaela, Petre Andreea Catalina, Tiliscan Catalin, Arama Stefan Sorin, Arama Victoria, Ion Daniela Adriana, Olariu Mihaela Cristina
Faculty of Medicine, University of Medicine and Pharmacy Carol Davila, No. 37, Dionisie Lupu Street, Sector 2, 020021 Bucharest, Romania.
National Institute for Infectious Diseases Prof. Dr. Matei Bals, No. 1, Calistrat Grozovici Street, Sector 2, 021105 Bucharest, Romania.
Diagnostics (Basel). 2024 Dec 13;14(24):2811. doi: 10.3390/diagnostics14242811.
BACKGROUND/OBJECTIVES: We aimed to characterize the fibrosis following COVID-19 pneumonia, using quantitative analysis, after three months and subsequently, after two years of patients' release from the hospital, and to identify the risk factors for pulmonary fibrosis.
We performed a retrospective, observational cohort study on 420 patients with severe forms of COVID-19. For all patients, we registered demographic, inflammatory and biochemical parameters, complete blood count and D-dimers; all patients underwent three computed tomography scans (at admittance, at 3 months and at 2 years).
We found fibrosis in 67.9% of patients at the 3-month evaluation and in 42.4% of patients at the 2-year evaluation, registering a significant decrease in the severe and moderate fibrosis cases, with a slight increase in the mild fibrosis cases. The risk of fibrosis was found to be proportional to the values of age, duration of hospital stay, inflammatory markers (ESR, fibrinogen), cytolytic markers (LDH, AST) and D-dimers. The highest correlations with lung fibrosis were registered for interstitial pulmonary involvement (for the 3-month evaluation) and total pulmonary involvement (for the 2-year evaluation).
Lung fibrosis represents a significant post-COVID-19 complication found in 42% of patients with severe forms of pneumonia at the 2-year evaluation. A significant overall decrease in the severity of lung fibrosis was registered at the 2-year evaluation compared to the 3-month evaluation. We consider that the amount of interstitial pulmonary involvement represents the optimal parameter to estimate the risk of lung fibrosis following SARS-CoV-2 pneumonia.
背景/目的：我们旨在通过定量分析，对新冠肺炎患者出院三个月后以及两年后的肺纤维化情况进行特征描述，并确定肺纤维化的风险因素。
我们对420例重症新冠肺炎患者进行了一项回顾性观察队列研究。对所有患者，我们记录了人口统计学、炎症和生化参数、全血细胞计数及D-二聚体；所有患者均接受了三次计算机断层扫描（入院时、3个月时和2年时）。
在3个月评估时，我们发现67.9%的患者存在纤维化，在2年评估时，42.4%的患者存在纤维化，重度和中度纤维化病例显著减少，轻度纤维化病例略有增加。发现纤维化风险与年龄、住院时间、炎症标志物（血沉、纤维蛋白原）、细胞溶解标志物（乳酸脱氢酶、谷草转氨酶）和D-二聚体的值成正比。与肺纤维化相关性最高的是间质性肺受累（3个月评估时）和全肺受累（2年评估时）。
肺纤维化是新冠肺炎后一种显著的并发症，在2年评估时，42%的重症肺炎患者存在该并发症。与3个月评估相比，2年评估时肺纤维化严重程度总体显著降低。我们认为，间质性肺受累程度是评估新型冠状病毒肺炎后肺纤维化风险的最佳参数。
