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Clinical status and lung function 10 weeks after severe SARS-CoV-2 infection
Respiratory Medicine ( IF 3.5 ) Pub Date : 2020-11-30 , DOI: 10.1016/j.rmed.2020.106276
Jelle Smet 1 , Dimitri Stylemans 1 , Shane Hanon 1 , Bart Ilsen 2 , Sylvia Verbanck 1 , Eef Vanderhelst 1
Affiliation  

Introduction

Since studies about clinical status after COVID-19 are scarce, we conducted a cross sectional study with assessment of residual symptoms, lung function and chest CT.

Materials and Methods

During an outpatient follow-up visit, chest CT, pulmonary function and COVID-19 related symptoms were assessed approximately 10 weeks after diagnosis. Demographics, baseline (time of diagnosis) CT score and blood results were collected from patient files. Association between lung function and clinical characteristics (baseline), blood markers (baseline), chest CT (baseline and follow-up) and symptom score (followup) was analysed. Mann-Whitney U tests and Chi squared tests were used for statistical comparison between subgroups with and without restriction.

Results and discussion

Two hundred-twenty subjects were evaluated at a median follow-up of 74±12 (SD) days. Median symptom and median CT score at follow-up were 1(IQR=0- 2) and 2(IQR=0-6) respectively. Forty-six percent of patients had normal lung function, while TLC and TLCO below the lower limit of normal were observed in 38% and 22% of subjects respectively. This restrictive pulmonary impairment was associated with length of hospital stay (8 vs 6 days; p=0.003), admission to the intensive care unit (27% vs 13%;p=0.009), and invasive mechanical ventilation (10% vs 0.7%;p=0.001), but not with symptom score or CT score at baseline and follow-up.

Conclusions

Fifty-four percent of COVID-19 survivors had abnormal lung function 10 weeks after diagnosis. Restriction was the most prevalent pulmonary function, with the more critically ill patients being more prone to this condition. Yet, restriction could not be linked with abnormal imaging results or residual symptoms.



中文翻译:

严重 SARS-CoV-2 感染后 10 周的临床状态和肺功能

介绍

由于关于 COVID-19 后临床状态的研究很少,我们进行了一项横断面研究,评估残留症状、肺功能和胸部 CT。

材料和方法

在门诊随访期间,诊断后约 10 周评估了胸部 CT、肺功能和 COVID-19 相关症状。从患者档案中收集人口统计学、基线(诊断时间)CT 评分和血液结果。分析了肺功能与临床特征(基线)、血液标志物(基线)、胸部 CT(基线和随访)和症状评分(随访)之间的关联。Mann-Whitney U 检验和卡方检验用于有限制和无限制的亚组之间的统计比较。

结果和讨论

在 74±12 (SD) 天的中位随访期间对 220 名受试者进行了评估。随访时中位症状和中位 CT 评分分别为 1(IQR=0-2)和 2(IQR=0-6)。46% 的患者肺功能正常,而分别有 38% 和 22% 的受试者观察到 TLC 和 TLCO 低于正常下限。这种限制性肺损伤与住院时间长短(8 对 6 天;p=0.003)、入住重症监护病房(27% 对 13%;p=0.009)和有创机械通气(10% 对 0.7%)有关;p=0.001),但与基线和随访时的症状评分或 CT 评分无关。

结论

54% 的 COVID-19 幸存者在诊断后 10 周出现肺功能异常。限制是最普遍的肺功能,病情越重的患者越容易出现这种情况。然而,限制不能与异常成像结果或残留症状联系起来。

更新日期:2020-12-02
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