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新型冠状病毒肺炎康复者六个月后胸部计算机断层扫描及肺功能测试异常情况评估

Assessment of the Abnormalities in Chest Computed Tomography and Pulmonary Function Test in Convalescents Six Months After COVID-19.

作者信息

Guziejko Katarzyna, Moniuszko-Malinowska Anna, Flisiak Robert, Czupryna Piotr, Sołomacha Sebastian, Sowa Paweł, Dubatówka Marlena, Łapińska Magda, Kiszkiel Łukasz, Szczerbiński Łukasz, Laskowski Piotr Paweł, Alimowski Maciej, Trojan Gabriela, Kamiński Karol Adam

机构信息

2nd Department of Lung Diseases, Lung Cancer and Internal Medicine, Medical University of Bialystok, 15-089 Bialystok, Poland.

Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, 15-089 Bialystok, Poland.

出版信息

Medicina (Kaunas). 2025 Apr 29;61(5):823. doi: 10.3390/medicina61050823.

Abstract

Despite the multiple waves of the COVID-19 pandemic, follow-up strategies for recovered patients remain inconclusive. This study aimed to evaluate chest computed tomography (CT) and pulmonary function test (PFT) abnormalities in convalescents six months after COVID-19 and to compare these findings with those from a representative population cohort. The goal was to support more individualized pulmonary management of post-COVID-19 sequelae. : This study population consisted of 2 groups: I-232 post-COVID-19 patients and II-543 patients from a population cohort. Chest CT was performed during the acute phase of COVID-19 and six months after. The PFTs were conducted six months after COVID-19. : There were no significant differences in FEV1, FVC, TLC, and DLCO in the two study groups. A singular GGO in 24 patients (20%), a crazy paving pattern in 1 patient (0.8%), thickening of interlobular septa in 4 patients (3.5%), consolidations in 4 patients (3.5%), traction bronchiectasis in 6 patients (5%), fibrosis in 6 patients (5%), and singular nodular densities in 68 patients (58%) were observed in chest CT 6 months after COVID-19. Most radiological abnormalities were clinically insignificant and did not require further diagnostic evaluation. No significant differences in chest CT and PFT six months after infection were observed between patients differing in the severity of inflammation during the acute disease or SARS-CoV-2 variant. : The majority of chest CT abnormalities resolved within six months of recovery, regardless of SARS-CoV-2 variant or initial disease severity. Pulmonary function tests should be prioritized in post-COVID-19 follow-up, as PFT results in convalescents were comparable to those observed in the general population.

摘要

尽管新冠疫情出现多波高峰,但康复患者的随访策略仍未明确。本研究旨在评估新冠康复者在感染新冠病毒六个月后的胸部计算机断层扫描(CT)和肺功能测试(PFT)异常情况,并将这些结果与具有代表性的人群队列进行比较。目的是为新冠后遗症的更个体化肺部管理提供支持。:本研究人群包括两组:I组为232名新冠康复患者,II组为来自人群队列的543名患者。在新冠急性期和六个月后进行胸部CT检查。肺功能测试在感染新冠病毒六个月后进行。:两个研究组的第一秒用力呼气容积(FEV1)、用力肺活量(FVC)、肺总量(TLC)和一氧化碳弥散量(DLCO)无显著差异。在感染新冠病毒六个月后的胸部CT检查中,观察到24名患者(20%)出现单个磨玻璃影(GGO),1名患者(0.8%)出现铺路石样改变,4名患者(3.5%)出现小叶间隔增厚,4名患者(3.5%)出现实变,6名患者(5%)出现牵拉性支气管扩张,6名患者(5%)出现纤维化,68名患者(58%)出现单个结节状密度影。大多数影像学异常在临床上无显著意义,无需进一步诊断评估。在急性疾病期间炎症严重程度不同或感染不同SARS-CoV-2变异株的患者之间,感染六个月后的胸部CT和肺功能测试无显著差异。:无论SARS-CoV-2变异株或初始疾病严重程度如何,大多数胸部CT异常在康复后六个月内消失。在新冠康复后的随访中,应优先进行肺功能测试,因为康复者的肺功能测试结果与普通人群相当。

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