Pulmonary function of 47 patients with COVID-19 in recovery period in Guangzhou

Abstract

Objective To explore and understand the injury degree of human lung induced by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2), through retrospectively analysis of the 47 patients’ pulmonary function in the period of recovery from COVID -19. Methods Totally 47 COVID-19 patients treated in Guangzhou Eighth People′s Hospital from January to February 2020, and isolated 14 days were selected as the research subjects. The detected results of pulmonary function, chest CT, and SARS-CoV-2 antibodies were retrospectively analyzed. Results In the 47 COVID-19 convalescent patients, 40 (85.1%) showed negative for IgM of SARS-CoV-2 and 44 (93.6%) showed positive for IgG, 7 showed positive for both IgM and IgG, and 3 showed negative for both IgM and IgG. 29 cases (61.7%) of pulmonary dysfunction, of which there were 19 mild, 10 moderate, 3 restrictive ventilation dysfunction, 1 obstructive ventilation dysfunction, 2 ventilation dysfunction, 1 mixed ventilation dysfunction, 26 diffusion ventilation dysfunction, 2 mixed diffusion & restrictive ventilation dysfunction, 1 mixed diffusion & obstructive ventilation dysfunction, 2 mixed diffusion & ventilation dysfunction, and 5 small airway dysfunction. 10 cases (90.9%) of pulmonary dysfunction in 11 severe COVID-19 patients, of which 4 were mild and 6 were moderate; 19 cases (52.8%) of pulmonary dysfunction in 36 general COVID-19 patients, of which 15 were mild and 4 were moderate; Comparing the two groups, the cases of pulmonary dysfunction in severe COVID-19 patients were more than general patients. 35 cases of abnormal chest CT in convalescent patients. The abnormal chest CT image mostly showed diffuse large ground glass-like shadows, scattered patchy shadows, and fiber strand shadows; 8 cases showed diffuse large ground glass and fiber strand shadows, of which 7 from moderate pulmonary dysfunction VS 1 from mild pulmonary dysfunction, 6 from severe COVID-19 patients VS 2 from general patients. Conclusion The majority of patients with COVID-19 in the recovery period have pulmonary dysfunction, which mostly manifests as diffuse dysfunction. The exploration is of certain clinical significance for guiding rehabilitation treatment. 摘要：目的 了解 47 例新型冠状病毒肺炎 (COVID-19) 患者恢复期肺功能状况, 分析新型冠状病毒对肺的损伤程 度, 为 COVID-19 致肺损伤恢复提供实验依据。 方法 选取 2020 年 1 月—2 月在广州市第八人民医院治愈出院, 隔离 14 d 后的 47 例 COVID-19 恢复期患者为研究对象, 对检测肺功能、胸部 CT、新型冠状病毒抗体结果进行回顾性分析。 结果 47 例恢复期 COVID-19 患者新型冠状病毒 IgM 阴性 40 例 (占 85.1%) , IgG 阳性 44 例 (占 93.6%) , 其中 IgM、IgG 均 阳性 7 例, IgM、IgG 均阴性 3 例。肺功能损障碍 29 例 (占 61.7%) , 其中轻度、中度障碍分别 19 例、10 例。限制性通气功 能障碍 3 例, 阻塞性通气功能障碍 1 例, 通气功能障碍 2 例, 混合通气功能障碍 1 例, 弥散功能障碍 26 例, 弥散并限制性 通气功能障碍 2 例, 弥散并阻塞性通气功能障碍 1 例, 弥散并通气功能障碍 2 例, 小气道功能障碍共 5 例。11 例重型 COVID-19 患者肺功能障碍 10 例 (占 90.9%) , 其中轻度 4 例, 中度 6 例, 36 例普通型患者肺功能障碍 19 例 (占 52.8%) , 其中 轻度 15 例, 中度 4 例, 两组对比重型 COVID-19 患者中度肺功能障碍较普通型多。恢复期患者胸部 CT 异常 35 例, 多表 现为弥漫大片状磨玻璃样影、散在斑片影、纤维条索影; 其中表现为弥漫大片磨玻璃影和纤维条索影者共 8 例, 中度肺 功能障碍患者 (7 例) 较轻度肺功能障碍患者多 (1 例) , 重型患者 (6 例) 较普通型患者 (2 例) 多。 结论 COVID-19 患者 恢复期绝大部分患者有肺功能障碍, 多表现为弥散功能障碍, 对指导康复治疗有一定临床意义。