来自SARS-CoV-2病毒间歇性肺炎的纤维结局结果
Luigi Pinto1, Pietro Schino1, Michele Bitetto1
1Respiratory Physiopathology and Bronchial Endoscopy Unit, Ecclesiastical Entity General Regional Hospital 'F. Miulli', Acquaviva Delle Fonti (BA). luigi.pinto@miulli.it.
概括
长期的COVID可能会导致长期的肺损伤,83.3%的患者在感染SARS-CoV-2后36个月内表现出残留疾病. 严重的病例更容易出现持续的间歇性肺炎和呼吸功能减弱.
科学领域:
- 肺部病理学 肺部病理学
- 传染性疾病 传染性疾病
- 放射学 放射学是指放射学
背景情况:
- 随着COVID-19大流行,人们需要了解SARS-CoV-2感染的长期结果.
- 间歇性肺炎是COVID-19的一个重要并发症,引发了人们对后炎性纤维化变化的担忧.
研究的目的:
- 评估COVID-19相关间歇性肺炎的演变成为后炎性纤维化间歇性疾病.
- 评估从SARS-CoV-2肺炎中康复的患者的长期肺部连续症状.
主要方法:
- 随访了42名患有SARS-CoV-2间歇性肺炎的患者队列.
- 评估包括炎症指数,高分辨率计算机断层扫描 (CT) 胸部扫描,以及多个时间点的功能性呼吸检测,直到出院后的36个月.
- 患者根据肺炎的严重程度和所需的呼吸支持 (仅有O2,非侵入性通风,侵入性机械通风) 进行了分层.
主要成果:
- 在36个月的随访期间,83.3%的患者表现出残留的帕伦基马性肺病.
- 严重的肺炎病例和具有更广泛的初始CT发现的病例显示了较高的残留疾病率.
- 放射学发现包括地面玻璃的不透明度,腹膜带和间歇性加厚,暗示有纤维变化.
- 观察到呼吸功能和运动能力降低,特别是在需要呼吸器支持的严重肺炎患者中 (24%的患者经历过脱和运动耐受性降低).
结论:
- 与COVID-19相关的间歇性肺炎可能导致持续的肺部疾病和纤维化变化,特别是在严重的情况下.
- 长期随访显示,在很大一部分患者中,显著的放射性和功能障碍.
- 初始肺炎和炎症状态的严重程度与肺病变和功能缺陷的程度和持续性相关.
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