Residual Lung Abnormalities after COVID-19 Hospitalization Interim Analysis of the UKILD Post-COVID-19 Study

被引：64

作者：

Stewart, Iain ^{[1
]}

Jacob, Joseph ^{[2
]}

George, Peter M. ^{[5
]}

Molyneaux, Philip L. ^{[1
]}

Porter, Joanna C. ^{[4
]}

Allen, Richard J. ^{[6
,7
]}

Aslani, Shahab ^{[2
]}

Baillie, J. Kenneth ^{[9
]}

Barratt, Shaney L. ^{[10
]}

Beirne, Paul ^{[11
]}

Bianchi, Stephen M. ^{[12
]}

Blaikley, John F. ^{[13
]}

Chalmers, James D. ^{[14
]}

Chambers, Rachel C. ^{[3
]}

Chadhuri, Nazia ^{[13
]}

Coleman, Christopher ^{[15
]}

Collier, Guilhem ^{[16
]}

Denneny, Emma K. ^{[4
]}

Docherty, Annemarie ^{[9
]}

Elneima, Omer ^{[7
]}

Evans, Rachael A. ^{[7
]}

Fabbri, Laura ^{[1
]}

Gibbons, Michael A. ^{[17
]}

Gleeson, Fergus, V ^{[18
]}

Gooptu, Bibek ^{[6
]}

Greening, Neil J. ^{[7
]}

Guio, Beatriz Guillen ^{[6
]}

Hall, Ian P. ^{[15
]}

Hanley, Neil A. ^{[13
]}

Harris, Victoria ^{[7
]}

Harrison, Ewen M. ^{[9
]}

Heightman, Melissa ^{[19
]}

Hillman, Toby E. ^{[19
]}

Horsley, Alex ^{[13
]}

Houchen-Wolloff, Linzy ^{[7
]}

Jarrold, Ian ^{[20
]}

Johnson, Simon R. ^{[15
]}

Jones, Mark G. ^{[21
]}

Khan, Fasihul ^{[15
]}

Lawson, Rod ^{[12
]}

Leavy, Olivia ^{[6
]}

Lone, Nazir ^{[8
]}

Marks, Michael ^{[19
]}

McAuley, Hamish ^{[7
]}

Mehta, Puja ^{[19
]}

Parekh, Dhruv ^{[22
]}

Hanley, Karen Piper ^{[13
,23
]}

Plate, Manuela ^{[19
]}

Pearl, John ^{[6
]}

Poinasamy, Krisnah ^{[20
]}

机构：

[1] Imperial Coll London, Natl Heart & Lung Inst, Emmanuel Kaye Bldg, London SW3 6LY, England

[2] Ctr Med Imaging Comp, London, England

[3] Resp Med, London, England

[4] UCL, London, England

[5] Guys & St Thomas NHS Fdn Trust, Royal Brompton & Harefield Clin Grp, London, England

[6] Univ Leicester, Dept Hlth Sci, Leicester, Leics, England

[7] Leicester NIHR Biomed Res Ctr, Leicester, Leics, England

[8] Usher Inst, Edinburgh, Midlothian, Scotland

[9] Univ Edinburgh, Edinburgh, Midlothian, Scotland

[10] North Bristol NHS Trust, Bristol, Avon, England

[11] Leeds Teaching Hosp NHS Fdn Trust, Leeds, W Yorkshire, England

[12] Sheffield Teaching Hosp NHS Fdn Trust, Sheffield, S Yorkshire, England

[13] Univ Manchester, Manchester, Lancs, England

[14] Ninewells Hosp & Med Sch, Dundee, Scotland

[15] Univ Nottingham, Nottingham, England

[16] Univ Sheffield, Sheffield, S Yorkshire, England

[17] Royal Devon & Exeter NHS Fdn Trust, Exeter, Devon, England

[18] Oxford Univ Hosp NHS Fdn Trust, Oxford, England

[19] Univ Coll London Hosp, London, England

[20] Asthma Lung UK, London, England

[21] Univ Southampton, Fac Med, Southampton, Hants, England

[22] Univ Birmingham, Birmingham, England

[23] Manchester Univ NHS Fdn Trust, Manchester, Lancs, England

[24] Univ Oxford, Oxford, England

[25] Univ Liverpool, Liverpool, Merseyside, England

[26] Newcastle Univ, Newcastle, NSW, Australia

[27] Perth Royal Infirm, NHS Tayside, Perth, Scotland

[28] Liverpool Univ Hosp NHS Fdn Trust, Liverpool, Merseyside, England

来源：

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE | 2023年 / 207卷 / 06期

基金：

英国科研创新办公室;

关键词：

COVID-19; hospitalization; HRCT; lung damage; lung abnormalities;

D O I：

10.1164/rccm.202203-0564OC

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Rationale: Shared symptoms and genetic architecture between coronavirus disease (COVID-19) and lung fibrosis suggest severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may lead to progressive lung damage. Objectives: The UK Interstitial Lung Disease Consortium (UKILD) post-COVID-19 study interim analysis was planned to estimate the prevalence of residual lung abnormalities in people hospitalized with COVID-19 on the basis of risk strata. Methods: The PHOSP-COVID-19 (Post-Hospitalization COVID-19) study was used to capture routine and research follow-up within 240 days from discharge. Thoracic computed tomography linked by PHOSP-COVID-19 identifiers was scored for the percentage of residual lung abnormalities (ground-glass opacities and reticulations). Risk factors in linked computed tomography were estimated with Bayesian binomial regression, and risk strata were generated. Numbers within strata were used to estimate posthospitalization prevalence using Bayesian binomial distributions. Sensitivity analysis was restricted to participants with protocol-driven research follow-up. Measurements and Main Results: The interim cohort comprised 3,700 people. Of 209 subjects with linked computed tomography (median, 119 d; interquartile range, 83-155), 166 people (79.4%) had more than 10% involvement of residual lung abnormalities. Risk factors included abnormal chest X-ray (risk ratio [RR], 1.21; 95% credible interval [CrI], 1.05-1.40), percent predicted DLCO less than 80% (RR, 1.25; 95% CrI, 1.00-1.56), and severe admission requiring ventilation support (RR, 1.27; 95% CrI, 1.07-1.55). In the remaining 3,491 people, moderate to very high risk of residual lung abnormalities was classified at 7.8%, and posthospitalization prevalence was estimated at 8.5% (95% CrI, 7.6-9.5), rising to 11.7% (95% CrI, 10.3-13.1) in the sensitivity analysis. Conclusions: Residual lung abnormalities were estimated in up to 11% of people discharged after COVID-19-related hospitalization. Health services should monitor at-risk individuals to elucidate long-term functional implications.

引用

页码：693 / 703

页数：11

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