Cherif Hela, Mokaddem Salma, Debiche Soumaya, Kalboussi Slim, Yangui Ferdaous, Charfi Mohamed Ridha
Pulmonology Department, Internal Security Forces Hospital, Tunis, Tunisia.
Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunis, Tunisia.
F1000Res. 2024 Dec 6;13:1497. doi: 10.12688/f1000research.152196.1. eCollection 2024.
This study investigates the incidence and predictive factors of Hyperventilation Syndrome (HVS) in patients after COVID 19 pneumonia, addressing the clinical overlap between these conditions.
A one-month prospective study was conducted, tracking survivors of COVID-19 pneumonia. Patients were evaluated for ongoing clinical status, including HVS and post-traumatic syndrome disorder (PTSD), using clinical questionnaires, mMRC, Post-COVID-19 Functional Status (PCFS) Score, Nijmegen score, and PTSD Checklist for DSM-5 questionnaire.
Our study included 222 patients (median age: 57 years, male predominance 62.6%). Somatic comorbidities, primarily metabolic disorders, were reported in 71.2% of cases. The majority had severe or critical infection forms (78.4%), and 91.9% experienced acute symptoms, with 86.5% having three or more symptom clusters. At one month follow-up, dyspnea (52.9%) and asthenia (21.7%) persisted. Functional limitations (PCFS Grade > 2) were observed in 19.6% of patients. The overall incidence of HVS was 158 per 1000 patients, and PTSD was 445 per 1000 patients. Multivariate logistic regression identified cognitive impairment (acute phase), persistent weight loss (post-COVID-19 phase), PCFS grade > 2, and PTSD as independent factors for developing HVS, with relative risks (RRs) of 3.47 (95%CI [1.48-8.31]; p = 0.004), 11.87 (95%CI [1.25-112.88]; p = 0.031), 3.24 (95%CI [1.34-7.86]; p = 0.009), and 5.98 (95%CI [2.27-15.77]; p < 0.001), respectively.
HVS is prevalent in the post-COVID-19 phase, affecting 15.6 % of survivors. Identified predictive factors suggest the convergence of psychosomatic pathophysiological mechanisms. Further research is crucial for a detailed understanding of these mechanisms in long COVID-19 patients.
本研究调查了新型冠状病毒肺炎（COVID-19）后患者中过度通气综合征（HVS）的发病率及预测因素，探讨了这些病症之间的临床重叠情况。
进行了为期一个月的前瞻性研究，追踪COVID-19肺炎幸存者。使用临床问卷、改良英国医学研究委员会（mMRC）呼吸困难量表、COVID-19后功能状态（PCFS）评分、奈梅亨评分以及DSM-5版创伤后应激障碍检查表，对患者的当前临床状况进行评估，包括HVS和创伤后应激障碍（PTSD）。
我们的研究纳入了222例患者（中位年龄：57岁，男性占62.6%）。71.2%的病例报告有躯体合并症，主要是代谢紊乱。大多数患者患有严重或危重型感染（78.4%），91.9%的患者出现急性症状，86.5%的患者有三个或更多症状群。在1个月的随访中，呼吸困难（52.9%）和乏力（21.7%）持续存在。19.6%的患者存在功能受限（PCFS分级>2）。HVS的总体发病率为每1000例患者中有158例，PTSD为每1000例患者中有445例。多因素逻辑回归分析确定认知障碍（急性期）、持续体重减轻（COVID-19后阶段）、PCFS分级>2以及PTSD是发生HVS的独立因素，相对风险（RR）分别为3.47（95%置信区间[1.48 - 8.31]；p = 0.004）、11.87（95%置信区间[1.25 - 112.88]；p = 0.031）、3.24（95%置信区间[1.34 - 7.86]；p = 0.009）和5.98（95%置信区间[2.27 - 15.77]；p < 0.001）。
HVS在COVID-19后阶段很常见，影响了15.6%的幸存者。已确定的预测因素表明心身病理生理机制存在趋同现象。进一步的研究对于深入了解长期COVID-19患者的这些机制至关重要。
