患有COVID-19后呼吸道症状的儿童的肺部评估:一项前性队列研究
Einat Shmueli1,2, Ophir Bar-On1, Ben Amir2
1Pulmonology Institute, Schneider Children's Medical Center of Israel, 14 Kaplan Street, Petach Tikva 49202, Israel.
儿科后COVID-19条件 (PCC) 在肺功能测试 (PFTs) 中经常呈现轻度阻塞模式,而不是在成年人中看到的扩散限制. 许多儿童随着时间的推移显示PFT的改善,这表明吸入器治疗的潜在益处.
科学领域:
- 儿科肺病学 儿科肺病学
- 传染性疾病 传染性疾病
- 呼吸系统医学 呼吸系统医学
背景情况:
- 成人后COVID-19状态 (PCC) 研究经常报告肺功能测试 (PFT) 异常,特别是扩散限制.
- 关于儿科PCC中PFTs的数据有限,需要进一步调查儿童的呼吸系统后果.
- 了解PCC儿童的PFT变化对于准确的诊断和管理至关重要.
研究的目的:
- 在被诊断为COVID-19后病情 (PCC) 的儿童中描述肺功能测试 (PFT) 异常.
- 评估儿科PCC患者中PFT的纵向变化.
- 确定COVID-19后出现呼吸系统症状的儿童中异常PFT的预测因素.
主要方法:
- 一项前性纵向研究,涉及184名患有确定的PCC和呼吸道疾病的儿童.
- 2020年11月至2022年12月期间从一个多学科诊所收集的数据.
- 进行了肺功能测试 (PFT),包括螺旋计,运动挑战测试,支气管扩展剂可逆性,肺体积,扩散能力和呼出的氧化.
主要成果:
- 在11%的儿童中观察到PFT的轻度阻塞模式,其中大多数儿童没有先前的喘诊断.
- 肺体积和扩散能力在很大程度上是正常的,与成年人的发现形成鲜明对比;在22%的患者中发现了氧化的增加.
- 随访PFT在33名儿童中显示出改善或正常化;年龄较大和特定的成像发现预测了阻塞性模式.
结论:
- 患有呼吸道症状的儿科PCC的主要PFT异常是轻度阻塞模式,通常没有喘病史.
- 与成年人不同,在这个儿科队列中没有观察到显著的扩散限制.
- 长期随访表明PFT改善,对于患有PFT异常风险因素的儿童,可以考虑实证吸入器治疗.
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