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One-year follow-up of chest CT findings in patients after SARS-CoV-2 infection
BMC Medicine ( IF 7.0 ) Pub Date : 2021-08-09 , DOI: 10.1186/s12916-021-02056-8
Yanfei Chen 1 , Cheng Ding 1 , Ling Yu 1 , Wanru Guo 1 , Xuewen Feng 1 , Liang Yu 1 , Junwei Su 1 , Ting Xu 1 , Cheng Ren 1 , Ding Shi 1 , Wenrui Wu 1 , Ping Yi 1 , Jun Liu 1 , Jingjing Tao 1 , Guanjing Lang 1 , Yongtao Li 1 , Min Xu 1 , Jifang Sheng 1 , Lanjuan Li 1 , Kaijin Xu 1
Affiliation  

Knowledge about the 1-year outcome of COVID-19 is limited. The aim of this study was to follow-up and evaluate lung abnormalities on serial computed tomography (CT) scans in patients with COVID-19 after hospital discharge. A prospective cohort study of patients with COVID-19 from the First Affiliated Hospital, Zhejiang University School of Medicine was conducted, with assessments of chest CT during hospitalization and at 2 weeks, 1 month, 3 months, 6 months, and 1 year after hospital discharge. Risk factors of residual CT opacities and the influence of residual CT abnormalities on pulmonary functions at 1 year were also evaluated. A total of 41 patients were followed in this study. Gradual recovery after hospital discharge was confirmed by the serial CT scores. Around 47% of the patients showed residual aberration on pulmonary CT with a median CT score of 0 (interquartile range (IQR) of 0–2) at 1 year after discharge, with ground-glass opacity (GGO) with reticular pattern as the major radiologic pattern. Patients with residual radiological abnormalities were older (p = 0.01), with higher rate in current smokers (p = 0.04), higher rate in hypertensives (p = 0.05), lower SaO2 (p = 0.004), and higher prevalence of secondary bacterial infections during acute phase (p = 0.02). Multiple logistic regression analyses indicated that age was a risk factor associated with residual radiological abnormalities (OR 1.08, 95% CI 1.01–1.15, p = 0.02). Pulmonary functions of total lung capacity (p = 0.008) and residual volume (p < 0.001) were reduced in patients with residual CT abnormalities and were negatively correlated with CT scores. During 1-year follow-up after discharge, COVID-19 survivors showed continuous improvement on chest CT. However, residual lesions could still be observed and correlated with lung volume parameters. The risk of developing residual CT opacities increases with age.

中文翻译:

SARS-CoV-2感染后患者胸部CT表现一年随访

关于 COVID-19 的一年结果的了解有限。本研究的目的是跟踪和评估出院后的 COVID-19 患者连续计算机断层扫描 (CT) 扫描的肺部异常情况。对浙江大学医学院附属第一医院 COVID-19 患者进行前瞻性队列研究,对住院期间及出院 2 周、1 个月、3 个月、6 个月和 1 年进行胸部 CT 评估释放。还评估了残留 CT 混浊的危险因素以及残留 CT 异常对 1 年时肺功能的影响。本研究共对 41 名患者进行了随访。系列 CT 评分证实出院后逐渐康复。出院后 1 年,约 47% 的患者在肺部 CT 上显示残余像差,中位 CT 评分为 0(四分位距 (IQR) 为 0-2),以网状图案的毛玻璃样混浊 (GGO) 为主放射学模式。残留放射学异常的患者年龄较大(p = 0.01),目前吸烟者的比例较高(p = 0.04),高血压患者的比例较高(p = 0.05),SaO2较低(p = 0.004),继发细菌感染的患病率较高急性期(p = 0.02)。多重逻辑回归分析表明,年龄是与残留放射学异常相关的危险因素(OR 1.08,95% CI 1.01-1.15,p = 0.02)。残留 CT 异常的患者的肺功能,即总肺容量 (p = 0.008) 和残气量 (p < 0.001) 均降低,且与 CT 评分呈负相关。在出院后 1 年的随访中,COVID-19 幸存者的胸部 CT 表现出持续改善。然而,仍然可以观察到残留病灶并与肺容量参数相关。出现残留 CT 混浊的风险随着年龄的增长而增加。
更新日期:2021-08-09
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