Impact of coronavirus disease 2019 on pulmonary function in early convalescence phase
Impact of coronavirus disease 2019 on pulmonary function in early convalescence phase
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DOI：
10.1186/s12931-020-01429-6
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发表时间：
2020-06-29
影响因子：
5.8
通讯作者：
Liu, Jing
中科院分区：
文献类型：
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作者：
Huang, Yiying;Tan, Cuiyan;Liu, Jing
目的 本研究探讨 2019 冠状病毒病（COVID-19）对恢复期早期肺功能的影响。方法对中山大学附属第五医院的COVID-19患者进行回顾性研究，连续评估包括肺容量（TLC）、肺量测定（FVC、FEV1）、肺一氧化碳弥散能力（DLCO）、呼吸肌力、6分钟步行距离（6MWD）以及出院30天时采集的高分辨率CT。结果 57 名患者完成了系列评估。其中非重症病例40例，重症病例17例。 31 名患者（54.3%）CT 发现异常。 43例（75.4%）患者肺功能检查发现异常。 6 名（10.5%）、5 名（8.7%）、25 名（43.8%）、7 名（12.3%）和 30 名（52.6%）患者的 FVC、FEV1、FEV1/FVC 比值、TLC 和 DLCO 值分别低于预测值的 80%。 28 名 (49.1%) 和 13 名 (22.8%) 患者的 PImax 和 PEmax 值低于相应预测值的 80%。与非重症病例相比，重症患者DLCO损伤发生率较高（75.6%vs42.5%，p = 0.019），肺总严重程度评分（TSS）和R20较高，预测TLC和6MWD百分比显着较低。随访期间未发现 TSS 与肺功能参数之间存在显着相关性。结论 一半以上的COVID-19患者在恢复期早期发现弥散能力受损、呼吸肌力量降低和肺部影像学异常。与非重症病例相比，重症患者DLCO损伤发生率更高，TLC下降和6MWD下降也更多。
Objective This study investigated the influence of Coronavirus Disease 2019 (COVID-19) on lung function in early convalescence phase. Methods A retrospective study of COVID-19 patients at the Fifth Affiliated Hospital of Sun Yat-sen University were conducted, with serial assessments including lung volumes (TLC), spirometry (FVC, FEV1), lung diffusing capacity for carbon monoxide (DLCO),respiratory muscle strength, 6-min walking distance (6MWD) and high resolution CT being collected at 30 days after discharged. Results Fifty-seven patients completed the serial assessments. There were 40 non-severe cases and 17 severe cases. Thirty-one patients (54.3%) had abnormal CT findings. Abnormalities were detected in the pulmonary function tests in 43 (75.4%) of the patients. Six (10.5%), 5(8.7%), 25(43.8%) 7(12.3%), and 30 (52.6%) patients had FVC, FEV1, FEV1/FVC ratio, TLC, and DLCO values less than 80% of predicted values, respectively. 28 (49.1%) and 13 (22.8%) patients had PImax and PEmax values less than 80% of the corresponding predicted values. Compared with non-severe cases, severe patients showed higher incidence of DLCO impairment (75.6%vs42.5%,p = 0.019), higher lung total severity score (TSS) and R20, and significantly lower percentage of predicted TLC and 6MWD. No significant correlation between TSS and pulmonary function parameters was found during follow-up visit. Conclusion Impaired diffusing-capacity, lower respiratory muscle strength, and lung imaging abnormalities were detected in more than half of the COVID-19 patients in early convalescence phase. Compared with non-severe cases, severe patients had a higher incidence of DLCO impairment and encountered more TLC decrease and 6MWD decline.