Follow-up chest radiographic findings in patients with MERS-CoV after recovery.
Follow-up chest radiographic findings in patients with MERS-CoV after recovery.
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DOI：
10.4103/ijri.ijri_469_16
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发表时间：
2017-07
期刊：
影响因子：
--
通讯作者：
Langer RD
中科院分区：
文献类型：
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作者：
Das KM;Lee EY;Singh R;Enani MA;Al Dossari K;Van Gorkom K;Larsson SG;Langer RD
评价临床症状改善后出院的中东呼吸综合征冠状病毒（MERS-CoV）患者的随访胸部X线检查结果。36例确诊MERS-CoV的连续患者（9例男性，27例女性;年龄范围21-73岁，平均值± SD 42. 5 ± 14. 5岁）在MERS-CoV恢复后接受了随访胸片。在32至230天获得了36张胸片，中位随访时间为43天。评审员系统评价了36例患者的随访胸片，以确定肺实质、气道、胸膜、肺门和纵隔异常。评估肺实质和气道的实变、磨玻璃样混浊（GGO）、结节性混浊和网状混浊（即，纤维化）。还评价了随访胸片的胸膜增厚、胸腔积液、气胸和淋巴结病。将患者分为两组：第1组（无肺纤维化证据）和第2组（胸部影像学肺纤维化证据）进行比较分析。采用Student t检验、Mann-Whitney U检验和Fisher精确检验比较两组患者的人口统计学资料、通气天数、重症监护室（ICU）住院天数、胸部影像学评分、胸部影像学恶化模式（1-4型）和峰值乳酸脱氢酶水平。36例患者中有23例（64%）的随访胸片正常。胸片异常者13例（36%），其中肺纤维化12例（33%），GGO 2例（5.5%），胸膜增厚2例（5.5%）。肺纤维化患者的ICU住院天数显著增加（19 ± 8.7天; P值= 0.001），年龄较大（50.6 ± 12.6岁; P值= 0.02），胸部放射学评分较高[10（0-15.3）; P值= 0.04]和较高的峰值乳酸脱氢酶水平（315-370 U/L; P值= 0.001）。肺纤维化可能在从中东呼吸综合征冠状病毒（MERS-CoV）中康复的大量患者中发展。在MERS CoV恢复后随访胸片上，肺纤维化患者的ICU住院天数、年龄、胸部影像学评分、胸部影像学恶化模式和乳酸脱氢酶峰值水平显著增加。
To evaluate the follow-up chest radiographic findings in patients with Middle East respiratory syndrome coronavirus (MERS-CoV) who were discharged from the hospital following improved clinical symptoms. Thirty-six consecutive patients (9 men, 27 women; age range 21–73 years, mean ± SD 42.5 ± 14.5 years) with confirmed MERS-CoV underwent follow-up chest radiographs after recovery from MERS-CoV. The 36 chest radiographs were obtained at 32 to 230 days with a median follow-up of 43 days. The reviewers systemically evaluated the follow-up chest radiographs from 36 patients for lung parenchymal, airway, pleural, hilar and mediastinal abnormalities. Lung parenchyma and airways were assessed for consolidation, ground-glass opacity (GGO), nodular opacity and reticular opacity (i.e., fibrosis). Follow-up chest radiographs were also evaluated for pleural thickening, pleural effusion, pneumothorax and lymphadenopathy. Patients were categorized into two groups: group 1 (no evidence of lung fibrosis) and group 2 (chest radiographic evidence of lung fibrosis) for comparative analysis. Patient demographics, length of ventilations days, number of intensive care unit (ICU) admission days, chest radiographic score, chest radiographic deterioration pattern (Types 1-4) and peak lactate dehydrogenase level were compared between the two groups using the student t-test, Mann-Whitney U test and Fisher's exact test. Follow-up chest radiographs were normal in 23 out of 36 (64%) patients. Among the patients with abnormal chest radiographs (13/36, 36%), the following were found: lung fibrosis in 12 (33%) patients GGO in 2 (5.5%) patients, and pleural thickening in 2 (5.5%) patients. Patients with lung fibrosis had significantly greater number of ICU admission days (19 ± 8.7 days; P value = 0.001), older age (50.6 ± 12.6 years; P value = 0.02), higher chest radiographic scores [10 (0-15.3); P value = 0.04] and higher peak lactate dehydrogenase levels (315-370 U/L; P value = 0.001) when compared to patients without lung fibrosis. Lung fibrosis may develop in a substantial number of patients who have recovered from Middle East respiratory syndrome coronavirus (MERS-CoV). Significantly greater number of ICU admission days, older age, higher chest radiographic scores, chest radiographic deterioration patterns and peak lactate dehydrogenase levels were noted in the patients with lung fibrosis on follow-up chest radiographs after recovery from MERS-CoV.