长 COVID 的预测因素以及住院的 COVID-19 患者与未入住重症监护室的患者在长 COVID 症状、胸部影像检查结果和肺功能方面的差异。

IF 3.5 3区 医学 Q2 RESPIRATORY SYSTEM Respiration Pub Date : 2024-01-01 Epub Date: 2024-02-28 DOI:10.1159/000535391
Maureen van Wincoop, Hazra S Moeniralam, Franz M N H Schramel
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引用次数: 0

摘要

导言:许多 COVID-19 幸存者在急性病后仍有后遗症。这种情况被称为长COVID。本研究旨在评估与长COVID相关的因素,并分析重症监护室(ICU)和非重症监护室住院患者在持续症状、胸部影像学检查结果和肺功能方面的差异。方法 我们对 COVID-19 的住院患者进行了回顾性研究。患者被分为重症监护室患者和非重症监护室患者。我们分析了出院后 6 个月仍有持续症状、放射学和/或功能异常的患者的临床随访结果。采用逻辑回归法研究 Long COVID 与患者特征之间的关系。结果 共纳入 549 名患者。有 81 名重症监护病房患者(66%)和 146 名非重症监护病房患者(34%)在出院后至少 6 个月的胸部成像或肺功能测试中出现持续症状或异常。在胸部 CT 上有残留纤维化异常和功能障碍的重症监护室患者明显更多。女性、心肌梗死、OSAS、入院时 PCO2 低和住院时间较长的患者患长 COVID 的风险较高。而糖尿病和使用托昔鲁齐单抗治疗的患者罹患长COVID的风险较低。结论 在因 COVID-19 而住院的患者中,34%-66% 的患者在出院后六个月左右会出现持续症状、胸部影像残留异常或肺功能下降。虽然持续性后遗症在重症监护病房患者中更为常见,但入住重症监护病房并不是罹患长COVID的独立风险因素。
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Predictors for Long COVID and Differences in Long COVID Symptoms, Findings on Chest Imaging and Pulmonary Function between Hospitalized COVID-19 Patients with versus without Intensive Care Unit Admission.

Introduction: Many COVID-19 survivors suffer from persisting sequelae after acute disease. This is referred to as long COVID. The objectives of this study were to assess factors associated with long COVID and to analyze differences in persistent symptoms, findings on chest imaging, and pulmonary function between intensive care unit (ICU) and non-ICU hospitalized patients.

Methods: We conducted a retrospective study including patients hospitalized with COVID-19. Patients were stratified into ICU patients and non-ICU patients. We analyzed the outcomes of patients who were in clinical follow-up 6 months after discharge with persistent symptoms, radiological and/or functional abnormalities. Logistic regression was used to examine the association between long COVID and patient characteristics.

Results: A total of 549 patients were included. Eighty-one ICU patients (66%) and 146 (34%) non-ICU patients had persistent symptoms or abnormalities on chest imaging or lung function test minimally 6 months after discharge. Significantly more ICU patients had residual fibrotic abnormalities on chest CT and functional impairment. Female gender, myocardial infarction, OSAS, low PCO2 at admission, and longer hospital stay were associated with a higher risk of developing long COVID. Diabetes and treatment with tocilizumab were associated with a lower risk of developing long COVID.

Conclusion: Of the patients hospitalized for COVID-19, 34-66% suffered from persistent symptoms, residual abnormalities on chest imaging, or reduced lung function at around 6 months after discharge. While persistent sequelae were more frequent in ICU patients, admission to the ICU was not found to be an independent risk factor for developing long COVID.

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来源期刊
Respiration
Respiration 医学-呼吸系统
CiteScore
7.30
自引率
5.40%
发文量
82
审稿时长
4-8 weeks
期刊介绍: ''Respiration'' brings together the results of both clinical and experimental investigations on all aspects of the respiratory system in health and disease. Clinical improvements in the diagnosis and treatment of chest and lung diseases are covered, as are the latest findings in physiology, biochemistry, pathology, immunology and pharmacology. The journal includes classic features such as editorials that accompany original articles in clinical and basic science research, reviews and letters to the editor. Further sections are: Technical Notes, The Eye Catcher, What’s Your Diagnosis?, The Opinion Corner, New Drugs in Respiratory Medicine, New Insights from Clinical Practice and Guidelines. ''Respiration'' is the official journal of the Swiss Society for Pneumology (SGP) and also home to the European Association for Bronchology and Interventional Pulmonology (EABIP), which occupies a dedicated section on Interventional Pulmonology in the journal. This modern mix of different features and a stringent peer-review process by a dedicated editorial board make ''Respiration'' a complete guide to progress in thoracic medicine.
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