American journal of respiratory and critical care medicine · 2023
Residual Lung Abnormalities after COVID-19 Hospitalization: Interim Analysis of the UKILD Post-COVID-19 Study.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Stewart Iain, Jacob Joseph, George Peter M, Molyneaux Philip L, Porter Joanna C, Allen Richard J, Aslani Shahab, Baillie J Kenneth, Barratt Shaney L, Beirne Paul, Bianchi Stephen M, Blaikley John F, Chalmers James D, Chambers Rachel C, Chadhuri Nazia, Coleman Christopher, Collier Guilhem, Denneny Emma K, Docherty Annemarie, Elneima Omer, Evans Rachael A, Fabbri Laura, Gibbons Michael A, Gleeson Fergus V, Gooptu Bibek, Greening Neil J, Guio Beatriz Guillen, Hall Ian P, Hanley Neil A, Harris Victoria, Harrison Ewen M, Heightman Melissa, Hillman Toby E, Horsley Alex, Houchen-Wolloff Linzy, Jarrold Ian, Johnson Simon R, Jones Mark G, Khan Fasihul, Lawson Rod, Leavy Olivia, Lone Nazir, Marks Michael, McAuley Hamish, Mehta Puja, Parekh Dhruv, Hanley Karen Piper, Platé Manuela, Pearl John, Poinasamy Krisnah, Quint Jennifer K, Raman Betty, Richardson Matthew, Rivera-Ortega Pilar, Saunders Laura, Saunders Ruth, Semple Malcolm G, Sereno Marco, Shikotra Aarti, Simpson A John, Singapuri Amisha, Smith David J F, Spears Mark, Spencer Lisa G, Stanel Stefan, Thickett David R, Thompson A A Roger, Thorpe Mathew, Walsh Simon L F, Walker Samantha, Weatherley Nicholas David, Weeks Mark E, Wild Jim M, Wootton Dan G, Brightling Chris E, Ho Ling-Pei, Wain Louise V, Jenkins Gisli R
Аннотация
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.