Altintas Izzet, Kallemose Thomas, Lindstrøm Mette Bendtz, Parvaiz Imran, Rokkedal Iben, Rasmussen Lene Juel, Iversen Katrine Kjær, Eugen-Olsen Jesper, Iversen Kasper Karmark, Hansen Ejvind Frausing, Ulrik Charlotte Suppli, Nehlin Jan Olof, Andersen Ove
Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, 2650 Hvidovre, Denmark.
Emergency Department, Copenhagen University Hospital Amager and Hvidovre, 2650 Hvidovre, Denmark.
J Clin Med. 2025 Mar 4;14(5):1717. doi: 10.3390/jcm14051717.
Pulmonary function impairment significantly affects quality of life, work ability, and healthcare utilization. Among patients with COVID-19, respiratory symptoms vary in severity. This study aimed to assess whether biomarkers related to respiratory function and inflammation at emergency department (ED) admittance can predict long-term pulmonary function impairment in COVID-19 survivors. This prospective single-center study recruited patients 4-5 months post-COVID-19 infection using consecutive sampling. All attendees at the respiratory outpatient clinic were invited to participate. Pulmonary function tests, including diffusing capacity of the lungs for carbon monoxide (DL), total lung capacity (TLC), forced expiratory volume in the first second (FEV1), and forced vital capacity (FVC), were performed, with DL < 80% as the key indicator of impairment. Baseline biomarkers-C-Reactive Protein (CRP), leukocyte counts, and soluble urokinase Plasminogen Activator Receptor (suPAR)-were correlated with post-discharge DL values. This study enrolled 110 patients with COVID-19; 58.2% were female, the median age was 61.5, and the average BMI was 27.2. Smoking history showed that 53.7% were never smokers, 43.5% were former smokers, and 2.8% were current smokers. A diffusion deficit (DL < 80%) was present in 48.6% of patients. Leukocyte counts and suPAR had the highest sensitivity (>0.80) for predicting DL impairment but showed low specificity and a positive predictive value (PPV) of around 0.50. However, combining all biomarkers improved prediction accuracy, with a negative predictive value (NPV) of 0.93. The chosen inflammatory biomarkers by themselves had a limited ability to predict long-term pulmonary function impairment in COVID-19 survivors. However, when combined, they demonstrated a high negative predictive value (NPV) for identifying DL impairment. This strategy could help clinicians better tailor follow-up care for patients with COVID-19.
肺功能损害会显著影响生活质量、工作能力和医疗保健利用率。在新冠肺炎患者中，呼吸道症状的严重程度各不相同。本研究旨在评估急诊科（ED）收治时与呼吸功能和炎症相关的生物标志物是否能够预测新冠肺炎幸存者的长期肺功能损害。这项前瞻性单中心研究采用连续抽样的方法，招募了感染新冠病毒4至5个月后的患者。呼吸门诊的所有就诊者均被邀请参与。进行了肺功能测试，包括肺一氧化碳弥散量（DL）、肺总量（TLC）、第1秒用力呼气量（FEV1）和用力肺活量（FVC），以DL<80%作为损害的关键指标。将基线生物标志物——C反应蛋白（CRP）、白细胞计数和可溶性尿激酶型纤溶酶原激活物受体（suPAR）与出院后的DL值进行关联分析。本研究纳入了110例新冠肺炎患者；其中58.2%为女性，中位年龄为61.5岁，平均体重指数为27.2。吸烟史显示，53.7%为从不吸烟者，43.5%为既往吸烟者，2.8%为当前吸烟者。48.6%的患者存在弥散功能障碍（DL<80%）。白细胞计数和suPAR对预测DL损害的敏感性最高（>0.80），但特异性较低，阳性预测值（PPV）约为0.50。然而，综合所有生物标志物可提高预测准确性，阴性预测值（NPV）为0.93。所选的炎症生物标志物本身预测新冠肺炎幸存者长期肺功能损害的能力有限。然而，联合使用时，它们对识别DL损害具有较高的阴性预测值（NPV）。这一策略可帮助临床医生更好地为新冠肺炎患者量身定制后续护理方案。
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