背景:自身免疫性肺泡蛋白沉积症(aPAP)是一种罕见的间质性肺病。COVID-19与既往肺部疾病患者的预后较差有关。但感染COVID-19后aPAP患者的预后尚不清楚。2022年12月,中国经历了SARS-CoV-2的Omicron变种的大规模爆发。在这项研究中,我们旨在探讨感染COVID-19的aPAP患者的临床结局。
结果:本研究共纳入39例aPAP患者。30.77%的患者在COVID-19感染后氧饱和度下降。我们比较了COVID-19感染后有或没有氧饱和度降低的两组患者,发现先前接受过氧治疗的患者(氧饱和度降低与非氧饱和度降低:6/12vs.4/27,P=0.043),基线动脉氧分压较低(74.50±13.61mmHgvs.86.49±11.92mmHg,P=0.009),较低基线DLCO/VA%[77.0(74.3,93.6)%与89.5(78.2,97.4)%,P=0.036],较短的基线6MWD[464(406,538)m与532(470,575)m,P=0.028],疾病严重程度评分较高(P=0.017),COVID-19感染后氧饱和度降低的可能性更大。
结论:基线呼吸不良的aPAP患者在COVID-19感染后发生缺氧的概率更高,但致命事件很少见.
BACKGROUND: Autoimmune pulmonary alveolar proteinosis (aPAP) is a rare interstitial lung disease. COVID-19 is associated with worse prognosis in previous lung diseases patients. But the prognosis of aPAP patients after infection with COVID-19 is unclear. In December 2022,
China experienced a large-scale outbreak of Omicron variant of the SARS-CoV-2. In this study, we aim to explore the clinical outcomes of aPAP patients infected with COVID-19.
RESULTS: A total of 39 aPAP patients were included in this study. 30.77% patients had a decrease in oxygen saturation after COVID-19 infection. We compared the two groups of patients with or without decreased oxygen saturation after COVID-19 infection and found that patients who had previous oxygen therapy (decreased oxygen saturation vs. non decreased oxygen saturation: 6/12 vs. 4/27, P = 0.043), with lower baseline arterial oxygen partial pressure (74.50 ± 13.61 mmHg vs. 86.49 ± 11.92 mmHg, P = 0.009), lower baseline DLCO/VA% [77.0 (74.3, 93.6) % vs. 89.5 (78.2, 97.4) %, P = 0.036], shorter baseline 6MWD [464 (406, 538) m vs. 532 (470, 575) m, P = 0.028], higher disease severity score (P = 0.017), were more likely to have decreased oxygen saturation after COVID-19 infection.
CONCLUSIONS: aPAP patients with poor baseline respiration have a higher probability of hypoxia after COVID-19 infection, but fatal events were rare.