在COVID-19肺炎后长期呼吸障碍患者的呼吸器效率
Daniel Piamonti1, Luigi Panza1, Roberto Flore1
1Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy.
Respiratory physiology & neurobiology
|June 2, 2024
概括
长期COVID患者经常经历持续的炼性呼吸不全,这表明呼吸系统效率降低,即使在感染后18个月. 这种肺功能受损与最初的COVID-19严重程度和肺损伤有关.
科学领域:
- 肺部病理学 肺部病理学
- 传染性疾病 传染性疾病
- 心脏呼吸系统医学 呼吸系统医学
背景情况:
- 长期COVID的特点是持续的症状,包括持续超过12周的疲劳性呼吸障碍,在SARS-CoV-2感染后持续超过12周.
- 长期COVID患者的运动性呼吸障碍,尽管基线肺功能测试正常,但可以持续存在.
研究的目的:
- 用心肺运动测试 (CPET) 调查长期COVID和运动性呼吸障碍患者的呼吸效率.
- 为了评估COVID-19肺炎后18个月和36个月的呼吸器效率.
主要方法:
- 预计将100名中度至危急的COVID-19患者纳入长期COVID计划.
- 高分辨率计算机断层扫描 (HRCT) 和肺功能测试在多个时间点进行.
- 心肺运动测试 (CPET) 在18个月和36个月后对残留呼吸障碍患者进行.
主要成果:
- 感染后18个月 (31.4±3.9 SD) 和36个月 (31.28±3.70 SD) 观察到呼吸器效率降低 (V'E/V'CO2倾斜).
- 在V'E/V'CO2斜率和初始肺部感染 (HRCT百分比和CT严重程度得分) 之间发现了正相关性.
- 在V'E/V'CO2斜率和肺部对一氧化碳 (DLCO) 的扩散能力之间存在负线性相关性,分别在3个月和15个月.
结论:
- 20%的患者在COVID-19后18个月仍报告有炼性呼吸障碍.
- 持续降低的呼吸系统效率,与初始的肺膜损伤和肺循环障碍有关,可能解释了长期COVID中持续的运动性呼吸障碍.
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