Small Airways Disease is a Post-Acute Sequelae of SARS-CoV-2 Infection
Small Airways Disease is a Post-Acute Sequelae of SARS-CoV-2 Infection
Abstract BackgroundThe sequelae of SARS-CoV-2 infection on pulmonary structure and function remain incompletely characterized. MethodsAdults with confirmed COVID-19 who remained symptomatic more than thirty days following diagnosis were enrolled and classified as ambulatory, hospitalized or requiring the intensive care unit (ICU) based on the highest level of care received during acute infection. Symptoms, pulmonary function tests and chest computed tomography (CT) findings were compared across groups and to healthy controls. CT images were quantitatively analyzed using supervised machine-learning to measure regional ground glass opacities (GGO) and image-matching to measure regional air trapping. Comparisons were performed using univariate analyses and multivariate linear regression. ResultsOf the 100 patients enrolled, 67 were in the ambulatory group. All groups commonly reported cough and dyspnea. Pulmonary function testing revealed restrictive physiology in the hospitalized and ICU groups but was normal in the ambulatory group. Among hospitalized and ICU patients, the mean percent of total lung classified as GGO was 13.2% and 28.7%, respectively, and was higher than in ambulatory patients (3.7%, P<0.001). The mean percentage of total lung affected by air trapping was 25.4%, 34.5% and 27.2% in the ambulatory, hospitalized and ICU groups and 7.3% in healthy controls (P<0.001). Air trapping measured by quantitative CT correlated with the residual volume to total lung capacity ratio (RV/TLC; ρ=0.6, P<0.001). ConclusionsAir trapping is present in patients with post-acute sequelae of COVID-19 and is independent of initial infection severity, suggesting obstruction at the level of the small airways. The long-term consequences are not known.
Pezzulo Alejandro A.、Zabner Joseph、Comellas Alejandro P.、Hoffman Eric A.、Blount Robert J.、Cho Josalyn L.、Hamzeh Nabeel Y.、Nagpal Prashant、Fortis Spyridon、Guo Junfeng、Villacreses Raul、Thurman Andrew L.
Division of Pulmonary, Critical Care and Occupational Medicine, Department of Internal Medicine, Iowa City Veterans Health AdministrationDivision of Pulmonary, Critical Care and Occupational Medicine, Department of Internal Medicine, Iowa City Veterans Health AdministrationDivision of Pulmonary, Critical Care and Occupational Medicine, Department of Internal Medicine, Iowa City Veterans Health AdministrationDivision of Pulmonary, Critical Care and Occupational Medicine, Department of Internal Medicine, Iowa City Veterans Health Administration||the Department of Radiology, Iowa City Veterans Health Administration||the Roy J. Carver Department of Biomedical Engineering, Iowa City Veterans Health AdministrationDivision of Pulmonary, Critical Care and Occupational Medicine, Department of Internal Medicine, Iowa City Veterans Health AdministrationDivision of Pulmonary, Critical Care and Occupational Medicine, Department of Internal Medicine, Iowa City Veterans Health AdministrationDivision of Pulmonary, Critical Care and Occupational Medicine, Department of Internal Medicine, Iowa City Veterans Health Administrationthe Department of Radiology, Iowa City Veterans Health AdministrationDivision of Pulmonary, Critical Care and Occupational Medicine, Department of Internal Medicine, Iowa City Veterans Health Administration||Carver College of Medicine, University of Iowa, and the Center for Access and Delivery Research and Evaluation, Iowa City Veterans Health Administrationthe Department of Radiology, Iowa City Veterans Health Administration||the Roy J. Carver Department of Biomedical Engineering, Iowa City Veterans Health AdministrationDivision of Pulmonary, Critical Care and Occupational Medicine, Department of Internal Medicine, Iowa City Veterans Health AdministrationDivision of Pulmonary, Critical Care and Occupational Medicine, Department of Internal Medicine, Iowa City Veterans Health Administration
医学研究方法内科学基础医学
Pezzulo Alejandro A.,Zabner Joseph,Comellas Alejandro P.,Hoffman Eric A.,Blount Robert J.,Cho Josalyn L.,Hamzeh Nabeel Y.,Nagpal Prashant,Fortis Spyridon,Guo Junfeng,Villacreses Raul,Thurman Andrew L..Small Airways Disease is a Post-Acute Sequelae of SARS-CoV-2 Infection[EB/OL].(2025-03-28)[2025-07-16].https://www.medrxiv.org/content/10.1101/2021.05.27.21257944.点此复制
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