COVID-19患者经常患有COVID-19后急性后遗症(PASC)。肺纤维化对患者的呼吸健康具有最显著的长期影响,称为COVID-19后肺纤维化(PC19-PF)。PC19-PF可由急性呼吸窘迫综合征(ARDS)或COVID-19引起的肺炎引起。出现COVID-19肺炎症状(包括咳嗽,呼吸急促,劳累时呼吸困难,和去饱和)诊断后至少12周,几乎所有开发PC19-PF。细胞外基质分子:层粘连蛋白(LN),IV型胶原蛋白(IVCol),前胶原IIIN末端肽(PIIINP),和透明质酸(HA)参与PC19-PF的发生和发展。本研究旨在探讨PC19-PF进展与血清层粘连蛋白水平的关系,IVCOL,PIIINP,和透明质酸。这项回顾性研究包括在深圳市龙岗区第三人民医院接受治疗的162例PC19-PF患者和160例健康对照。河北中石油中心医院、长治市人民医院2021年1月至2023年12月。血清LN水平,IVCOL,PIIINP,和HA通过使用商业试剂盒的化学发光免疫测定法检测。预测强迫肺活量百分比(FVC%pred),预测的一氧化碳肺扩散能力百分比(DLCO%pred),评估高分辨率计算机断层扫描(HRCT)评分,并将患者死亡率与健康对照进行比较。血清LN水平,IVCol,PIIINP,PC19-PF或CTD-ILD患者的HA明显高于健康对照组(均p<0.05),并且在急性加重病例中进一步升高(均p<0.01)。在患者中,HA与HRCT评分呈正相关,与FVC%pred和DLCO%pred呈负相关(均p<0.05)。血清LN水平,IVCOL,PIIINP,存活患者的HA明显低于死亡患者(均p>0.05)。血清LN水平,IVC,PIIINP,和HA可能影响PC19-PF的进展,并可作为PC19-PF严重程度的指标.
COVID-19 patients often suffer from post-COVID-19 acute sequelae (
PASC). Pulmonary fibrosis has the most significant long-term impact on the respiratory health of patients, known as post-COVID-19 pulmonary fibrosis (PC19-PF). PC19-PF can be caused by acute respiratory distress syndrome (ARDS) or COVID-19-induced pneumonia. Individuals who experience COVID-19 pneumonia symptoms (including cough, shortness of breath, dyspnea on exertion, and desaturation) for at least 12 weeks after diagnosis, almost all develop PC19-PF. Extracellular matrix molecules: laminin (LN), type IV collagen (IV Col), procollagen III N-terminal peptide (PIIINP), and hyaluronic acid (HA) are involved in the development and progression of PC19-PF. This study aimed to investigate the relationship between the progression of PC19-PF and serum levels of laminin, IV COL, PIIINP, and hyaluronic acid. This retrospective study included 162 PC19-PF patients treated and 160 healthy controls who received treatment at Shenzhen Longgang District Third People\'s Hospital, Hebei PetroChina Central Hospital and Changzhi People\'s Hospital from January 2021 to December 2023. Serum levels of LN, IV COL, PIIINP, and HA were detected by chemiluminescence immunoassay using commercial kits. Predicted forced vital capacity percentage (FVC% pred), predicted carbon monoxide lung diffusion capacity percentage (DLCO% pred), high-resolution computed tomography (HRCT) scores were assessed, and patient mortality was compared with healthy controls. Serum levels of LN, IV Col, PIIINP, and HA were significantly higher in PC19-PF or CTD-ILD patients than in healthy controls (all p < 0.05), and they were further elevated in acute exacerbation cases (all p < 0.01). In patients, HA was positively associated with HRCT scores and negatively associated with FVC% pred and DLCO% pred (all p < 0.05). Serum levels of LN, IV COL, PIIINP, and HA were significantly lower in surviving patients than in those who deceased (all p > 0.05). Serum levels of LN, IV C, PIIINP, and HA may affect the progression of PC19-PF and may serve as indicators of PC19-PF severity.