دورية أكاديمية
أعرض في EDS

Post-COVID-19 respiratory sequelae two years after hospitalization: an ambidirectional study.

التفاصيل البيبلوغرافية
العنوان: Post-COVID-19 respiratory sequelae two years after hospitalization: an ambidirectional study.
المؤلفون: Ribeiro Carvalho CR; Division of Pulmonary Medicine, Heart Institute, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil., Lamas CA; Division of Pulmonary Medicine, Heart Institute, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil., Visani de Luna LA; Division of Pulmonary Medicine, Heart Institute, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil., Chate RC; Radiology Institute, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil., Salge JM; Division of Pulmonary Medicine, Heart Institute, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil., Yamada Sawamura MV; Radiology Institute, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil., Toufen C; Division of Pulmonary Medicine, Heart Institute, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil., Garcia ML; Division of Pulmonary Medicine, Heart Institute, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil., Scudeller PG; Division of Pulmonary Medicine, Heart Institute, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil., Nomura CH; Radiology Institute, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil., Gutierrez MA; Division of Informatics, Heart Institute, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil., Baldi BG; Division of Pulmonary Medicine, Heart Institute, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
مؤلفون مشاركون: HCFMUSP Covid-19 Study Group
المصدر: Lancet regional health. Americas [Lancet Reg Health Am] 2024 Apr 17; Vol. 33, pp. 100733. Date of Electronic Publication: 2024 Apr 17 (Print Publication: 2024).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Ltd Country of Publication: England NLM ID: 9918232503006676 Publication Model: eCollection Cited Medium: Internet ISSN: 2667-193X (Electronic) Linking ISSN: 2667193X NLM ISO Abbreviation: Lancet Reg Health Am Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: [Oxford] : Elsevier Ltd., [2021]-
مستخلص: Background: COVID-19 lung sequelae can impact the course of patient lives. We investigated the evolution of pulmonary abnormalities in post-COVID-19 patients 18-24 months after hospital discharge.
Methods: A cohort of COVID-19 patients admitted to the Hospital das Clínicas da Faculdade de Medicina da USP in São Paulo, Brazil, between March and August of 2020, were followed-up 6-12 months after hospital discharge. A subset of patients with pulmonary involvement and chest computed tomography (CT) scans were eligible to participate in this second follow-up (18-24 months). Data was analyzed in an ambidirectional manner, including retrospective data from the hospitalization, and from the first follow-up (6-12 months after discharge), and compared with the prospective data collected in this new follow-up.
Findings: From 348 patients eligible, 237 (68%) participated in this follow-up. Among participants, 139 (58%) patients presented ground-glass opacities and reticulations, and 80 (33%) presented fibrotic-like lesions (traction bronchiectasis and architectural distortion). Five (2%) patients improved compared to the 6-12-month assessment, but 20 (25%) of 80 presented worsening of lung abnormalities. For those with relevant assessments on both occasions, comparing the CT findings between this follow-up with the previous assessment, there was an increase in patients with architectural distortion (43 [21%] of 204 vs 57 [28%] of 204, p = 0.0093), as well as in traction bronchiectasis (55 [27%] of 204 vs 69 [34%] of 204, p = 0.0043). Patients presented a persistent functional impairment with demonstrated restrictive pattern in both follow-ups (87 [42%] of 207 vs 91 [44%] of 207, p = 0.76), as well as for the reduced diffusion capacity (88 [42%] of 208 vs 87 [42%] of 208, p = 1.0). Length of hospitalization (OR 1.04 [1.01-1.07], p = 0.0040), invasive mechanical ventilation (OR 3.11 [1.3-7.5] p = 0.011), patient's age (OR 1.03 [1.01-1.06] p = 0.0074 were consistent predictors for development of fibrotic-like lung lesions in post-COVID-19 patients.
Interpretation: Post-COVID-19 lung sequelae can persist and progress after hospital discharge, suggesting airways involvement and formation of new fibrotic-like lesions, mainly in patients who were in intensive care unit (ICU).
Funding: São Paulo Research Foundation (22/01769-5) and Instituto Todos pela Saúde (C1721).
Competing Interests: We declare no competing interests.
(© 2024 The Authors.)
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فهرسة مساهمة: Keywords: Ambidirectional cohort; COVID-19; Fibrosis; Lung CT; PASC; Pulmonary function; Small airways disease
تواريخ الأحداث: Date Created: 20240429 Latest Revision: 20240430
رمز التحديث: 20240430
مُعرف محوري في PubMed: PMC11047789
DOI: 10.1016/j.lana.2024.100733
PMID: 38680501
قاعدة البيانات: MEDLINE
الوصف
تدمد:2667-193X
DOI:10.1016/j.lana.2024.100733