Robert Sykes, Andrew J Morrow, Kenneth Mangion, Alex McConnachie, Alasdair McIntosh, Giles Roditi, Liam Peng, Claire Rooney, Kathryn Scott, David Barrie Stobo, Colin Berry, Colin Church, Hannah Bayes
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This included serial blood biomarkers and patient-reported outcomes 28-60 days following discharge from hospital.</p><p><strong>Results: </strong>Of the COVID-19 cohort, 88 (56%) patients of the COVID-19 cohort (n = 159; mean age, 55 years; 43% female) had persisting radiological abnormalities at 28-60 days postdischarge. This included ground-glass opacification (45%), reticulation/architectural distortion (30%) or mixed pattern (19%). These features were very infrequent among a group of age-matched, sex-matched and cardiovascular risk factor-matched controls (n=29). The majority of COVID-19 cohort (68%) had less than 20% persisting radiological abnormalities, with 67% demonstrating overall improvement compared with admission imaging. Older age, premorbid performance status, typical acute COVID-19 radiological features, markers of severe acute COVID-19, convalescent ICAM-1 and P-selectin were associated with persisting lung abnormalities (all p<0.05). 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引用次数: 0
摘要
背景：covid -19后的放射学轨迹尚不确定。我们提出了一项前瞻性、观察性、多中心队列研究，使用多模态成像来描述COVID-19住院患者的肺部后遗症、持续异常放射学的预测因素以及对健康状况的影响。方法：作为CISCO-19研究（ClinicalTrials.gov ID NCT04403607）的一部分，我们对COVID-19幸存者进行了恢复期CT肺血管造影和高分辨率CT成像。这包括一系列血液生物标志物和出院后28-60天患者报告的结果。结果：在COVID-19队列中，88例（56%）患者(n = 159；平均年龄55岁；43%女性)在出院后28-60天有持续的放射学异常。这包括磨砂玻璃不透明（45%），网状/建筑变形（30%）或混合图案（19%）。这些特征在年龄匹配、性别匹配和心血管危险因素匹配的对照组中非常少见（n=29）。大多数COVID-19队列（68%）的持续放射学异常不到20%，与入院影像相比，67%的患者总体改善。年龄、发病前运动状态、典型急性COVID-19放射学特征、严重急性COVID-19标志物、恢复期ICAM-1和p -选择素与持续肺部异常相关（均为p2）（均为p）。结论：COVID-19后持续放射学异常在出院后28-60天很常见，尽管大多数有所改善。出院后28-60天持续放射学异常的患者有长期持续健康损害的风险，代表有针对性干预的人群。试验注册号：NCT04403607。
Radiological abnormalities persist following COVID-19 and correlate with impaired health-related quality of life: a prospective cohort study of hospitalised patients.
Background: The radiological trajectory of post-COVID-19 is uncertain. We present a prospective, observational, multicentre cohort study using multimodality imaging to describe the pulmonary sequelae of patients hospitalised with COVID-19, predictors of persistent abnormal radiology and implications on health status.
Methods: In survivors of COVID-19, we performed convalescent CT pulmonary angiogram and high-resolution CT imaging as part of the CISCO-19 study (ClinicalTrials.gov ID NCT04403607). This included serial blood biomarkers and patient-reported outcomes 28-60 days following discharge from hospital.
Results: Of the COVID-19 cohort, 88 (56%) patients of the COVID-19 cohort (n = 159; mean age, 55 years; 43% female) had persisting radiological abnormalities at 28-60 days postdischarge. This included ground-glass opacification (45%), reticulation/architectural distortion (30%) or mixed pattern (19%). These features were very infrequent among a group of age-matched, sex-matched and cardiovascular risk factor-matched controls (n=29). The majority of COVID-19 cohort (68%) had less than 20% persisting radiological abnormalities, with 67% demonstrating overall improvement compared with admission imaging. Older age, premorbid performance status, typical acute COVID-19 radiological features, markers of severe acute COVID-19, convalescent ICAM-1 and P-selectin were associated with persisting lung abnormalities (all p<0.05). Patients with persisting abnormalities were shown to have lower levels of physical activity and predicted maximal oxygen utilisation (derived VO2) (both p<0.05). Higher percentage of abnormal lung parenchyma was associated with lower patient-assessed quality of life (EQ-5D-5L) score (p=0.03).
Conclusions: Persistent radiological abnormalities post-COVID-19 were common at 28-60 days postdischarge from hospital, although most improved. Patients with persisting radiological abnormalities 28-60 days postdischarge are at risk of persisting health impairment in the longer term and represent a population for targeted intervention.
期刊介绍：
BMJ Open Respiratory Research is a peer-reviewed, open access journal publishing respiratory and critical care medicine. It is the sister journal to Thorax and co-owned by the British Thoracic Society and BMJ. The journal focuses on robustness of methodology and scientific rigour with less emphasis on novelty or perceived impact. BMJ Open Respiratory Research operates a rapid review process, with continuous publication online, ensuring timely, up-to-date research is available worldwide. The journal publishes review articles and all research study types: Basic science including laboratory based experiments and animal models, Pilot studies or proof of concept, Observational studies, Study protocols, Registries, Clinical trials from phase I to multicentre randomised clinical trials, Systematic reviews and meta-analyses.
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