瑞典COVID-19ICU幸存者的长期肺功能轨迹:为期两年的随访研究
Marta A Kisiel1, Emil Ekbom2, Christer Janson2
1Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
European clinical respiratory journal
|January 26, 2026
概括
在危急的COVID-19发生两年后,三分之一的患者仍然对一氧化碳 (DLco) 的扩散能力有损. 这凸显了肺部随访的必要性,以解决持续的肺功能缺陷.
科学领域:
- 肺部病理学 肺部病理学
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
背景情况:
- 关于COVID-19肺功能重症监护室 (ICU) 入院的长度研究是有限的.
- 了解长期呼吸系统后果对于患者管理至关重要.
研究的目的:
- 在ICU出院后两年内调查COVID-19幸存者的肺功能.
- 确定与一氧化碳 (DLco) 扩散能力受损相关的因素.
主要方法:
- 一组接受乌普萨拉重症监护室治疗的COVID-19患者在出院后被跟踪了两年.
- 使用螺旋计,一氧化碳 (DLco) 的扩散能力,以及四个月,一年和两年后的身体囊造影来评估肺功能.
- 逻辑回归被用来分析受损DLco和患者特征之间的关联,根据年龄,性别和BMI进行调整.
主要成果:
- 缺陷的DLco存在于50%的4个月,58%的1年和33%的2年.
- 预测的DLco%从4个月下降到1年,但在1到2年之间显著改善.
- 强迫生命能力 (FVC) 和1秒内强迫呼吸量 (FEV) 也随着时间的推移而有所改善.
- 4个月后DLco受损与年龄较大,机械呼吸,更长的ICU停留时间,淋巴细胞数量较低和FVC/FEV1减少有关.
结论:
- 尽管康复,但很大一部分患者在临界后的两年内患有持续的DLco损伤.
- 肺部随访对于这些患者的长期肺功能缺陷的管理至关重要.
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