2020年株洲地区63例新冠肺炎患者出院后的随访研究

Follow up of 63 discharged patients with COVID-19 in Zhuzhou area in 2020

目的:观察疫情初期新冠肺炎患者出院后的临床特征、实验室检查及影像学指标变化。方法:选取2020年1—3月我院收治的株洲地区63例新冠肺炎患者,出院后对其进行6个月随访。观察患者的临床症状、血常规、肝肾功能、新冠病毒核酸及抗体、肺功能及肺部CT的变化。结果:部分患者出院6个月仍有胸闷、髋关节痛、腹泻等不适症状。患者出院1个月、出院6个月的白细胞计数及淋巴细胞计数与入院时比较差异有统计学意义(P<0.05);入院时与出院6个月的肝功能指标比较差异有统计学意义(P<0.05);出院1个月与6个月的FVC、FEV1、VC及DLCO比较差异有统计学意义(P<0.05)。42.9%的患者出院6个月IgG仍为阳性,58.7%的患者肺部CT仍未恢复正常。结论:疫情初期新冠肺炎患者出院后多数有影像学上的肺部改变,需要进一步随访以确定这些患者的肺功能何时可以完全恢复。白细胞介导的炎症可能与肺弥散功能恢复有关。

Objective:To observe the changes of clinical characteristics, laboratory examination and imaging indexes in patients with COVID-19 after discharge at the beginning of the epidemic.Methods:63 patients with COVID-19 admitted to our hospital in Zhuzhou area from January to March 2020 were selected. They were followed up for 6 months after discharge to observe the changes of clinical symptoms, routine blood test, liver and kidney functions, nucleic acid and antibody of SARS-CoV-2, pulmonary function and pulmonary CT.Results:Some patients still had chest tightness, coxalgia, diarrhea and other discomfort symptoms at the 6th months after discharge. The WBC and LYM at the 1stmonth and the 6th month after discharge were significantly different from those at admission(P<0.05). There were statistically significant differences in liver function indexes between admission and at the 6th month after discharge(P<0.05). The FVC, FEV1, VC and DLCO of patients at 1st month after discharge were significantly different from those at the 6th months after discharge(P<0.05). At the 6th month after discharge, 42.9% of patients were still positive for IgG and 58.7% of the patients’ pulmonary CT had not returned to normal.Conclusion:Most patients with COVID-19 admitted to our hospital at the beginning of the epidemic have pulmonary changes on imaging. Therefore, further follow-up is needed to determine when the pulmonary function of these patients can be fully recovered. Leukocyte mediated inflammation may be related to the recovery of pulmonary diffusion function.