Henry Sonya S, Wang Stephen H, Hou Wei, Duong Tim Q
Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, 1300 Morris Park Avenue, Bronx, NY, 10461, USA.
Center for Health & Data Innovation, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA.
Sci Rep. 2025 Aug 13;15(1):29746. doi: 10.1038/s41598-025-15347-4.
This retrospective cohort study used propensity-matched cohorts with a 3-year follow-up (March 2020-July 2023) to determine incidence rates, relative risks, and risk factors for incident pulmonary conditions after COVID-19 exposure. Data were drawn from a multi-center health system in New York City. Participants had at least 30 days of follow-up and included patients with or without COVID-19 confirmed by PCR, diagnosed with lower respiratory tract infection (LRTI), or without COVID-19/LRTI testing. COVID-19 status was defined by positive PCR, LRTI requiring hospitalization, or neither. The final cohort (n = 69,632) comprised 1:1 propensity-matched comparisons based on age, sex, race/ethnicity, obesity, type II diabetes, hypertension, and smoking, stratified by hospitalization. Primary outcomes were incidence rates, hazard ratios (HRs), and incidence rate ratios (IRRs) for new-onset pulmonary conditions. The study included 34,816 matched COVID-19 survivors and 34,816 non-COVID survivors. Non-hospitalized COVID-19 patients had a threefold higher risk of incident pulmonary conditions compared to non-COVID controls (aHR = 3.36, 95% CI: 3.02-3.73). Hospitalized COVID-19 patients showed similar risk to hospitalized LRTI controls (aHR = 1.24, 95% CI: 0.84-1.84). Multiple sensitivity analyses were conducted. COVID-19 increases pulmonary risk in non-hospitalized patients but not in hospitalized cohorts compared with LRTI. These findings underscore the need for monitoring and intervention in at-risk individuals.
这项回顾性队列研究采用倾向匹配队列，并进行了为期3年的随访（2020年3月至2023年7月），以确定新冠病毒暴露后新发肺部疾病的发病率、相对风险和风险因素。数据来自纽约市的一个多中心医疗系统。参与者至少有30天的随访时间，包括经聚合酶链反应（PCR）确诊或未确诊新冠病毒、被诊断为下呼吸道感染（LRTI）或未进行新冠病毒/LRTI检测的患者。新冠病毒感染状态通过PCR阳性、需要住院治疗的LRTI或两者均无来定义。最终队列（n = 69,632）包括根据年龄、性别、种族/族裔、肥胖、II型糖尿病、高血压和吸烟情况进行1:1倾向匹配的对照，并按住院情况进行分层。主要结局是新发肺部疾病的发病率、风险比（HRs）和发病率比（IRRs）。该研究纳入了34,816名匹配的新冠病毒感染幸存者和34,816名非新冠病毒感染幸存者。与非新冠病毒感染对照组相比，未住院的新冠病毒感染患者发生肺部疾病的风险高出三倍（校正HR = 3.36，95%置信区间：3.02 - 3.73）。住院的新冠病毒感染患者与住院的LRTI对照组风险相似（校正HR = 1.24，95%置信区间：0.84 - 1.84）。进行了多项敏感性分析。与LRTI相比，新冠病毒感染增加了未住院患者的肺部疾病风险，但在住院队列中未增加。这些发现强调了对高危个体进行监测和干预的必要性。
