Respiratory and Psychophysical Sequelae Among Patients With COVID-19 Four Months After Hospital Discharge.
Respiratory and Psychophysical Sequelae Among Patients With COVID-19 Four Months After Hospital Discharge.
复制标题
DOI：
10.1001/jamanetworkopen.2020.36142
复制
发表时间：
2021-01-04
影响因子：
13.8
通讯作者：
Pirisi M
中科院分区：
文献类型：
--
作者：
Bellan M;Soddu D;Balbo PE;Baricich A;Zeppegno P;Avanzi GC;Baldon G;Bartolomei G;Battaglia M;Battistini S;Binda V;Borg M;Cantaluppi V;Castello LM;Clivati E;Cisari C;Costanzo M;Croce A;Cuneo D;De Benedittis C;De Vecchi S;Feggi A;Gai M;Gambaro E;Gattoni E;Gramaglia C;Grisafi L;Guerriero C;Hayden E;Jona A;Invernizzi M;Lorenzini L;Loreti L;Martelli M;Marzullo P;Matino E;Panero A;Parachini E;Patrucco F;Patti G;Pirovano A;Prosperini P;Quaglino R;Rigamonti C;Sainaghi PP;Vecchi C;Zecca E;Pirisi M
哪些呼吸、功能和心理后遗症与2019年冠状病毒病的康复有关(新冠肺炎)？在这项对在意大利北部一家学术医院住院的238名新冠肺炎患者进行的队列研究中，超过一半的参与者一氧化碳弥散性肺活量或可测量的功能障碍显著减少，约五分之一的患者在出院4个月后出现创伤后应激症状。这些发现表明，尽管病毒学上有所恢复，但相当大比例的新冠肺炎患者在出院几个月后出现呼吸、功能或心理后遗症。这项队列研究调查了2019年严重冠状病毒病幸存者的患病率和与肺功能或身体损伤或创伤后应激症状相关的风险因素(新冠肺炎)。尽管存在大量关于2019年严重冠状病毒病(新冠肺炎)的临床表现、病程、病死率和与死亡相关的风险因素的数据，但新冠肺炎幸存者的长期呼吸道和功能性后遗症尚不清楚。[目的]了解新冠肺炎住院患者出院4个月后肺功能异常、运动功能受损及心理后遗症的发生率。这项在意大利北部一家学术医院进行的前瞻性队列研究是在一系列连续的18岁及以上患者(或他们的护理人员)中进行的，这些患者在2020年3月1日至6月29日期间被确诊为严重的急性呼吸道冠状病毒2型(SARS-CoV-2)感染，需要住院治疗。SARS-CoV-2感染通过逆转录-聚合酶链式反应检测、支气管拭子、血清学检测或提示的计算机断层扫描结果来确认。严重的新冠肺炎需要住院治疗。研究的主要结果是描述了弥散性肺一氧化碳容量(DLCO)低于预期值80%的患者的比例。次要结果包括患有严重肺功能损害的患者的比例(定义为DLCO及lt；60%的预期值)；有创伤后应激症状的患者的比例(使用事件影响量表-修订的总分衡量)；功能受损的患者的比例(使用短身体运动成套测验[SPPB]评分和2分钟步行试验进行评估)；以及确定与DLCO减少和心理或功能后遗症相关的因素。在因严重新冠肺炎入院的767例患者中，494例(64.4%)拒绝参与，35例(4.6%)在随访中死亡。共有238名患者(31.0%)(中位数[四分位数范围]年龄61[50-71]岁；男性142[59.7%]；中位数[四分位数范围]合并症2[1-3])同意参与研究。在这些患者中，219名患者能够完成肺功能测试和DLCO测量。113例(51.6%)DLCO降至估计值的80%以下，34例(15.5%)DLCO降至60%以下。SPPB评分显示有53名患者(22.3%)活动受限(评分11)。SPPB评分在参考范围内的患者接受了2分钟步行试验，75名患者(40.5%)的年龄和性别超出了预期表现的参考范围；因此，共有128名患者(53.8%)有功能障碍。共有41名患者(17.2%)出现创伤后应激症状。这些发现表明，在出院4个月后，因新冠肺炎住院的患者中，呼吸、身体和心理后遗症是常见的。
What respiratory, functional, and psychological sequalae are associated with recovery from coronavirus disease 2019 (COVID-19)? In this cohort study of 238 patients with COVID-19 hospitalized in an academic hospital in Northern Italy, more than half of participants had a significant reduction of diffusing lung capacity for carbon monoxide or measurable functional impairment and approximately one-fifth of patients had symptoms of posttraumatic stress 4 months after discharge. These findings suggest that despite virological recovery, a sizable proportion of patients with COVID-19 experienced respiratory, functional, or psychological sequelae months after hospital discharge. This cohort study examines prevalence and risk factors associated with lung function or physical impairment or posttraumatic stress symptoms among survivors of severe coronavirus disease 2019 (COVID-19). Although plenty of data exist regarding clinical manifestations, course, case fatality rate, and risk factors associated with mortality in severe coronavirus disease 2019 (COVID-19), long-term respiratory and functional sequelae in survivors of COVID-19 are unknown. To evaluate the prevalence of lung function anomalies, exercise function impairment, and psychological sequelae among patients hospitalized for COVID-19, 4 months after discharge. This prospective cohort study at an academic hospital in Northern Italy was conducted among a consecutive series of patients aged 18 years and older (or their caregivers) who had received a confirmed diagnosis of severe acute respiratory coronavirus 2 (SARS-CoV-2) infection severe enough to require hospital admission from March 1 to June 29, 2020. SARS-CoV-2 infection was confirmed via reverse transcription–polymerase chain reaction testing, bronchial swab, serological testing, or suggestive computed tomography results. Severe COVID-19 requiring hospitalization. The primary outcome of the study was to describe the proportion of patients with a diffusing lung capacity for carbon monoxide (Dlco) less than 80% of expected value. Secondary outcomes included proportion of patients with severe lung function impairment (defined as Dlco <60% expected value); proportion of patients with posttraumatic stress symptoms (measured using the Impact of Event Scale–Revised total score); proportion of patients with functional impairment (assessed using the Short Physical Performance Battery [SPPB] score and 2-minute walking test); and identification of factors associated with Dlco reduction and psychological or functional sequelae. Among 767 patients hospitalized for severe COVID-19, 494 (64.4%) refused to participate, and 35 (4.6%) died during follow-up. A total of 238 patients (31.0%) (median [interquartile range] age, 61 [50-71] years; 142 [59.7%] men; median [interquartile range] comorbidities, 2 [1-3]) consented to participate to the study. Of these, 219 patients were able to complete both pulmonary function tests and Dlco measurement. Dlco was reduced to less than 80% of the estimated value in 113 patients (51.6%) and less than 60% in 34 patients (15.5%). The SPPB score was suggested limited mobility (score <11) in 53 patients (22.3%). Patients with SPPB scores within reference range underwent a 2-minute walk test, which was outside reference ranges of expected performance for age and sex in 75 patients (40.5%); thus, a total of 128 patients (53.8%) had functional impairment. Posttraumatic stress symptoms were reported in a total of 41 patients (17.2%). These findings suggest that at 4 months after discharge, respiratory, physical, and psychological sequelae were common among patients who had been hospitalized for COVID-19.
登录
查看更多内容
DOI：
10.2147/copd.s94377
发表时间：
2015
影响因子：
2.8
作者：
Bernabeu-Mora R;Medina-Mirapeix F;Llamazares-Herrán E;García-Guillamón G;Giménez-Giménez LM;Sánchez-Nieto JM
通讯作者：
Sánchez-Nieto JM
影响因子：
2.5
作者：
Hajikhani B;Calcagno T;Nasiri MJ;Jamshidi P;Dadashi M;Goudarzi M;Eshraghi AA;FACS;Mirsaeidi M
通讯作者：
Mirsaeidi M
影响因子：
6.3
作者：
Farrell, Timothy W.;Ferrante, Lauren E.;Saliba, Debra
通讯作者：
Saliba, Debra
影响因子：
5.5
作者：
Olfert, IM;Balouch, J;Hopkins, SR
通讯作者：
Hopkins, SR
DOI：
10.3390/healthcare8040373
发表时间：
2020-09-30
期刊：
Healthcare (Basel, Switzerland)
影响因子：
--
作者：
Chang MC;Park D
通讯作者：
Park D