Kajiwara Mateus Satoru, Lamas Celina Almeida, Luna Luis Augusto Visani de, Yokoyama Thais Suemi, de Oliveira Pedro Rizzi, Chate Rodrigo Caruso, Sawamura Marcio Valente Yamada, Imamura Marta, Carvalho Carlos Roberto Ribeiro de, Salge João Marcos
Instituto do Coração, Divisão de Pneumologia, Universidade de São Paulo Hospital das Clínicas, São Paulo, São Paulo, Brazil.
Instituto de Radiologia, Universidade de São Paulo Hospital das Clínicas, São Paulo, São Paulo, Brazil.
BMJ Open. 2025 Jul 13;15(7):e097338. doi: 10.1136/bmjopen-2024-097338.
Post-COVID-19 conditions (PCC) may include pulmonary sequelae, fatigue and other symptoms, but its mechanisms are not fully elucidated.
This study investigated the correlation between fatigue and the presence of pulmonary abnormalities in PCC patients with respiratory involvement 6-12 months after hospitalisation.
Cross-sectional study.
A tertiary hospital in Brazil.
315 patients, aged ≥18 years, were considered eligible based on SARS-CoV-2 infection confirmed by reverse transcription-PCR.
Pulmonary function tests (PFT), cardiopulmonary exercise tests (CPET), chest CT and hand grip were performed. The following scales were applied: Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scale, Euroqol 5 Dimensions quality of life (EQ-5D) and Hospital Anxiety and Depression Scale (HADS). Participants were divided between the fatigue group (FACIT-F≤30) and the non-fatigue group (FACIT-F>30). For the statistical analysis, the primary outcome was the difference in the diffusing capacity of the lungs for carbon monoxide (DLCO) between groups. Considered secondary outcomes were differences in PFT, CPET, chest CT, hand grip, EQ-5D and HADS.
The fatigue group had 81 patients (25.7%) against 234 (74.3%). PFT and CPET showed no significant difference in DLCO and oxygen consumption peak values between groups. The fatigue group had a lower workload (mean 55.3±21.3 watts vs 66.5±23.2 watts, p=0.003), higher breathing reserve (median 41.9% (33.8-52.5) vs 37.7% (28.9-47.1), p=0.028) and lower prevalence of ground glass opacity (60.8% vs 77.7%, p=0.003) and reticulation (36.7% vs 54.9%, p=0.005) in chest CT. The fatigue group had higher anxiety (57% vs 24%, p<0.001), depression (50.6% vs 13.6%, p<0.001), lower health-related quality of life (median 50 (32-63) vs 80 (61.3-88.3), p<0.001) and lower hand grip strength (median 15.8 (6-21) kgf vs 21 (12.1-30) kgf, p<0.001).
Fatigue in patients with PCC 6-12 months after hospitalisation is relatively common and had weak correlation with pulmonary disorders. Our results suggested fatigue could be strongly related with peripheral disorders such as reduced musculoskeletal strength or psychosocial limitations.
新冠后状况（PCC）可能包括肺部后遗症、疲劳及其他症状，但其机制尚未完全阐明。
本研究调查了住院6至12个月后有呼吸受累的PCC患者中疲劳与肺部异常之间的相关性。
横断面研究。
巴西一家三级医院。
315名年龄≥18岁的患者，基于逆转录聚合酶链反应确诊的SARS-CoV-2感染被认为符合条件。
进行了肺功能测试（PFT）、心肺运动测试（CPET）、胸部CT和握力测试。应用了以下量表：慢性病治疗功能评估-疲劳（FACIT-F）量表、欧洲五维健康量表（EQ-5D）和医院焦虑抑郁量表（HADS）。参与者被分为疲劳组（FACIT-F≤30）和非疲劳组（FACIT-F>30）。对于统计分析，主要结局是两组之间一氧化碳肺弥散量（DLCO）的差异。次要结局包括PFT、CPET、胸部CT、握力、EQ-5D和HADS的差异。
疲劳组有81名患者（25.7%），非疲劳组有234名患者（74.3%）。PFT和CPET显示两组之间DLCO和耗氧量峰值无显著差异。疲劳组的工作量较低（平均55.3±21.3瓦对66.5±23.2瓦，p=0.003），呼吸储备较高（中位数41.9%（33.8-52.5）对37.7%（28.9-47.1），p=0.028），胸部CT中磨玻璃影（60.8%对77.7%，p=0.003）和网状影（36.7%对54.9%，p=0.005）的患病率较低。疲劳组的焦虑（57%对24%，p<0.001）、抑郁（50.6%对13.6%，p<0.001）程度较高，健康相关生活质量较低（中位数50（32-63）对80（61.3-88.3），p<0.001），握力较低（中位数15.8（6-21）千克力对21（12.1-
