Eizaguirre Saioa, Sabater Gladis, Comas-Cufí Marc, Belda Sonia, Calderón Juan Carlos, Pineda Victor, Bonnin-Vilaplana Marc, Orriols Ramon
Respiratory and Radiology Departments, Dr. Josep Trueta University Hospital of Girona, and Santa Caterina Hospital of Salt, Girona Biomedical Research Institute (IDIBGI)Avinguda de França s/n, Girona, Catalonia, 17003, Spain.
Department of Medical Sciences, Faculty of Medicine, University of Girona, Girona, Catalonia, Spain.
BMC Pulm Med. 2025 Jul 2;25(1):302. doi: 10.1186/s12890-025-03772-0.
We aimed to describe respiratory sequelae up to 4 years after discharge in COVID-19 patients with severe pneumonia having required non-invasive respiratory support therapies.
This study was conducted between March 2020 and June 2020 at University Hospital Doctor Josep Trueta (Girona, Spain). We assessed the patient's dyspnoea and performed, pulmonary function tests, a high-resolution CT (HRCT), a 6-minute walking test, a blood test, and the Saint George's respiratory questionnaire 3 months after discharge. At the 6-month, 1-year, and 4-year follow-up, we repeated all tests except for pulmonary function, 6-min walking test, and HRCT, which were only performed if abnormal findings had been previously detected.
94 patients were enrolled 3 months after discharge; 73% were male, the median age was 62.9 years, and most were non-smokers (58%). 56 patients (59.6%) completed the 4-year follow-up. When comparing data 3 months and 4 years after discharge, the percentage of patients presenting dyspnoea ≥ 2 decreased (19.5% vs. 7.9%), the quality-of-life total score improved (22.8% vs. 18.1%), diffusing capacity for carbon monoxide improved (75.9% vs. 81.4%), the 6-min walking test distance was enhanced (368.0 m vs. 436.6 m), ground glass opacities findings waned (56.6% vs. 0.8%), and traction bronchiectasis increased (2.7% vs. 9.2%). Age was the only parameter that exhibited significant differences between patients with and without pulmonary fibrotic-like changes.
Most patients, 4 years after discharge, improved their pulmonary function, exercise capacity, clinical condition, and quality of life. Although pulmonary fibrotic-like changes were observed during the follow-ups, its disparity with clinical-functional improvement pointed to non-progressive and non-clinically relevant lung scars.
我们旨在描述在需要无创呼吸支持治疗的重症肺炎新冠患者出院后长达4年的呼吸后遗症情况。
本研究于2020年3月至2020年6月在西班牙赫罗纳市的何塞普·特鲁埃塔大学医院开展。我们在患者出院3个月后评估其呼吸困难情况，并进行肺功能测试、高分辨率CT（HRCT）、6分钟步行试验、血液检查以及圣乔治呼吸问卷。在6个月、1年和4年随访时，除肺功能、6分钟步行试验和HRCT外，我们重复所有测试，只有之前检测到异常结果时才进行肺功能、6分钟步行试验和HRCT。
94名患者在出院3个月后入组；73%为男性，中位年龄为62.9岁，大多数为非吸烟者（58%）。56名患者（59.6%）完成了4年随访。比较出院3个月和4年后的数据时，出现呼吸困难≥2级的患者百分比下降（19.5%对7.9%），生活质量总分改善（22.8%对18.1%），一氧化碳弥散能力改善（75.9%对81.4%），6分钟步行试验距离增加（368.0米对436.6米），磨玻璃影表现减少（56.6%对0.8%），牵拉性支气管扩张增加（2.7%对9.2%）。年龄是有和无肺纤维化样改变患者之间唯一表现出显著差异的参数。
大多数患者在出院4年后，肺功能、运动能力、临床状况和生活质量均有所改善。尽管在随访期间观察到肺纤维化样改变，但其与临床功能改善的差异表明为非进行性且与临床无关的肺部瘢痕。
