The UK Interstitial Lung Disease Long-COVID19 study (UKILD-Long COVID): understanding the burden of Interstitial Lung Disease in Long COVID.

许多正在康复的COVID-19患者都有长期症状，包括呼吸困难和疲劳，即所谓的“长期COVID”。最近的数据表明，10-20%不住院的患者和40-60%出院的患者患有长冠状病毒病的症状。COVID-19大流行导致全球大量感染者，其中相当多的人需要医院护理。仅在英国，已知感染人数就超过350万人，其中35万多人住院，2.5万多人住进重症监护室。入院最常见的原因是COVID - 19肺炎。如果进展为成人呼吸窘迫综合征，患者可能会被送进重症监护病房，在那里他们可能会被放置呼吸机以支持他们度过疾病。最近的分析表明，炎症性和瘢痕性肺部疾病（称为间质性肺疾病- ILD）是COVID - 19肺炎的主要并发症，约占出院患者的20%。据认为，从重症监护病房出院的患者中，这一数字甚至更高。虽然受影响的确切人数尚不清楚，但迫切需要确定和预防这种可能导致不可逆疤痕的潜在严重并发症的发展。因此，为了改善COVID-19肺炎幸存者的预后，我们将开展一项临床研究，以确定在COVID-19之后有多少人会发生ILD，他们会发生什么类型的ILD（主要是炎症还是瘢痕形成），以及为什么会这样。我们将询问可能患有ILD的患者是否愿意进行CT扫描以确认他们是否患有这种疾病。如果他们这样做，我们将邀请这些患者接受一系列新技术的调查。其中包括氙磁共振成像，以更详细地分析肺不同部位功能的变化，以及支气管肺泡灌洗，以分析肺细胞，以了解COVID-19的严重程度或其治疗方法是否对ild的发展产生影响。我们将确定COVID-19是否主要导致炎症性或瘢痕性疾病，以及这种疾病在出院后的一年内是好转还是恶化。最后，我们将尝试了解为什么一些患者在COVID-19后会患上严重的肺部疾病，而另一些患者则不会，并确定增加长期瘢痕形成风险的血液标记物和基因，以便我们确定如何治疗患者并防止实质性瘢痕形成。了解这些问题将有助于我们制定治疗策略，以防止COVID-19感染后出现严重疤痕和残疾。

Many recovering COVID-19 patients suffer from long term symptoms, including breathlessness and fatigue, so-called "Long COVID". Recent data suggest that between 10-20% of patients who do not go into hospital and 40-60% of people discharged from hospital suffer from symptoms of Long COVID.The COVID-19 pandemic has led to a huge number of infected people throughout the world with a substantial number requiring hospital-based care. In the UK alone, there have been over 3.5 million people known to be infected of whom more than 350,000 people were hospitalised, with over 25,000 admitted to intensive care units. The commonest reason for hospital admission is COVID pneumonitis. If this progresses to Adult Respiratory Distress Syndrome, patients may be admitted to Intensive Care Wards , where they could be placed on a ventilator to support them through their illness.Recent analysis indicates that inflammatory and scarring lung diseases (known as Interstitial Lung diseases - ILD) are a major complication of COVID pneumonitis and occur in approximately 20% of patients discharged from hospital. The figure is thought to be even higher in patients discharged from Intensive Care Units. Although the exact number of people affected is not yet known, there is an urgent need to identify and prevent the development of this potential severe complication, which can lead to irreversible scarring.Therefore, to improve outcomes for survivors of COVID pneumonitis we will undertake a clinical study to identify how many people develop ILD following COVID-19, what types of ILD they develop (is it predominantly inflammation or scarring) and why they do so. We will ask patients with possible ILD if they would be willing to have a CT scan to confirm whether they have this disease. If they do, we will invite these patients to undergo investigations using a range of new technologies. These will include Xenon Magnetic Resonance Imaging to get more detailed analysis of the changes in the function of different parts of the lung and Bronchoalveolar Lavage to analyse cells from the lung to understand whether the severity of COVID-19 or its treatments make a difference to the development of ILDs. We will identify whether COVID-19 leads primarily to either inflammatory or scarring disease and whether this disease gets better or worse in the year after they are discharged from hospital. Finally, we will try to understand why some patients get severe lung disease following COVID-19, and others don't, and identify blood markers and genes that increase the risk of developing long-term scarring, so that we can determine how to treat patients and prevent the development of substantial scarring.Understanding these questions will help us to develop treatment strategies to prevent the development of severe scarring and disability following COVID-19 infection.