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匈牙利一家三级转诊医院的新冠后综合征患病率及心肺特征

Prevalence and Cardiopulmonary Characteristics of Post-COVID Syndrome at a Hungarian Tertiary Referral Hospital.

作者信息

Fekete Krisztina, Sándor Barbara, Kacsó Anita, Pálfi Anita, Tóth Szilard, Deres László, Szabados Eszter, Czopf László, Rábai Miklós, Gál Roland, Alexy Tamas, Habon Tamás, Tóth Kálmán, Alizadeh Hussain, Soós Szilvia, Halmosi Róbert

机构信息

Division of Cardiology, First Department of Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary.

Szentágothai Research Centre, University of Pécs, 7624 Pécs, Hungary.

出版信息

J Clin Med. 2025 Apr 10;14(8):2604. doi: 10.3390/jcm14082604.

Abstract

After an acute COVID-19 infection, many patients suffered from various complaints called as post-COVID syndrome. Our post-COVID outpatient department was operational for 19 months, where patients (n = 252) underwent a detailed cardiopulmonary examination within a 3-month-long follow-up period. Most patients (69.9%) had mild acute symptoms with a higher hospitalization risk with preexisting hypertension ( < 0.05) and diabetes ( < 0.001). Most common post-COVID symptoms were fatigue (29.4%) and dyspnea (19.1%). Echocardiographic parameters showed no abnormalities and did not change during the follow-up period. Exercise capacity was also generally normal with no change over time; however, 9.9% of patients showed significant desaturation during a 6 min walk test. This finding showed correlation ( < 0.01) with decreased diffusion capacity (DLCO). Generally, DLCO improved slightly but significantly ( < 0.05) by the end of the follow-up period (from 72.4% to 74.1%). Our key finding was a 10× higher prevalence (24.6%) of lupus anticoagulant positivity among post-COVID patients compared to the normal population (estimated at 2-4%). In conclusion, post-COVID syndrome is a common consequence even after a mild infection. Severe infections tend to lead to worse cardiopulmonary outcomes. Higher prevalence of lupus anticoagulant positivity may underline the importance of autoimmunity in the pathomechanism of post-COVID syndrome.

摘要

在急性新冠病毒感染后,许多患者出现了各种不适症状,被称为新冠后综合征。我们的新冠后门诊运行了19个月,252名患者在长达3个月的随访期内接受了详细的心肺检查。大多数患者(69.9%)急性症状较轻,但合并高血压(<0.05)和糖尿病(<0.001)时住院风险更高。最常见的新冠后症状是疲劳(29.4%)和呼吸困难(19.1%)。超声心动图参数未显示异常,且在随访期间未发生变化。运动能力总体也正常,未随时间改变;然而,9.9%的患者在6分钟步行试验中出现明显的血氧饱和度下降。这一发现与弥散功能(DLCO)降低相关(<0.01)。一般来说,到随访期末,DLCO略有但显著改善(<0.05)(从72.4%升至74.1%)。我们的关键发现是,与正常人群(估计为2%-4%)相比,新冠后患者狼疮抗凝物阳性的患病率高10倍(24.6%)。总之,即使是轻度感染后,新冠后综合征也是常见的后果。严重感染往往导致更差的心肺结局。狼疮抗凝物阳性的较高患病率可能凸显了自身免疫在新冠后综合征发病机制中的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d3d1/12028108/888db310be8c/jcm-14-02604-g001.jpg

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