Previous Coronavirus Disease-2019 Infection and Lung Mechanics in Surgical Patients: A Hospital Registry Study.

IF 4.6 2区医学 Q1 ANESTHESIOLOGY

Anesthesia and analgesia Pub Date : 2024-11-01 Epub Date: 2024-07-26 DOI:10.1213/ANE.0000000000007015

Aiman Suleiman, Ricardo Munoz-Acuna, Simone Redaelli, Elena Ahrens, Tim M Tartler, Sarah Ashrafian, May M Hashish, Abeer Santarisi, Guanqing Chen, Stefan Riedel, Daniel Talmor, Elias N Baedorf Kassis, Maximilian S Schaefer, Valerie Goodspeed

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引用次数: 0

Abstract

Background: Long-term pulmonary complications have been reported after a coronavirus disease-2019 (COVID-19). We hypothesized that a history of COVID-19 is associated with a measurable decrease in baseline respiratory system compliance in patients undergoing general anesthesia.

Methods: In this hospital registry study, we included adult patients undergoing general anesthesia between January 2020 and March 2022 at a tertiary health care network in Massachusetts. We excluded patients with an American Society of Anesthesiologists physical status >IV, laryngoscopic surgeries, and patients who arrived intubated. The primary exposure was a history of COVID-19. The primary outcome was baseline respiratory system compliance (mL/cmH 2 O). Effects of severity of infection, surges (Alpha 1 , Alpha 2 , Delta, and Omicron), patient demographics, and time between infection and assessment of compliance were investigated.

Results: A total of 19,921 patients were included. Approximately 1386 (7.0%) patients had a history of COVID-19. A history of COVID-19 at any time before surgery was associated with a measurably lower baseline respiratory system compliance (ratio of means adj = 0.96; 95% confidence interval [CI], 0.94-0.97; P < .001; adjusted compliance difference: -1.6 mL/cmH 2 O). The association was more pronounced in patients with a severe form of COVID-19 (ratio of means adj = 0.95; 95% CI, 0.90-0.99; P = .02, adjusted compliance difference: -2 mL/cmH 2 O). Alpha 1 , Alpha 2 , and Delta surges, but not Omicron, led to a lower baseline respiratory system compliance ( P < .001, P = .02, and P < .001). The Delta surge effect was magnified in Hispanic ethnicity ( P -for-interaction = 0.003; ratio of means adj = 0.83; 95% CI, 0.74-0.93; P = .001; adjusted compliance difference: -4.6 mL/cmH 2 O).

Conclusions: A history of COVID-19 infection during Alpha 1 , Alpha 2 , and Delta surges was associated with a measurably lower baseline respiratory system compliance.

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先前的冠状病毒 Disease-2019 感染与手术患者的肺功能：一项医院登记研究

背景：据报道，冠状病毒病-2019（COVID-19）后出现了长期肺部并发症。我们假设，在接受全身麻醉的患者中，COVID-19 病史与呼吸系统基线顺应性的显著下降有关：在这项医院登记研究中，我们纳入了 2020 年 1 月至 2022 年 3 月期间在马萨诸塞州一家三级医疗保健网络接受全身麻醉的成年患者。我们排除了美国麻醉医师协会身体状况>IV级的患者、喉镜手术患者和插管患者。主要接触因素为 COVID-19 病史。主要结果是基线呼吸系统顺应性（mL/cmH2O）。研究还调查了感染严重程度、涌流（Alpha1、Alpha2、Delta 和 Omicron）、患者人口统计学特征以及感染与顺应性评估之间时间的影响：共纳入 19921 名患者。约有 1386 名患者（7.0%）曾感染过 COVID-19。术前任何时候有 COVID-19 病史与基线呼吸系统顺应性明显降低有关（均值比 adj = 0.96；95% 置信区间 [CI]，0.94-0.97；P < .001；调整后的顺应性差异为-1.6 mL/cmH)-1.6毫升/厘米水）。这种关联在 COVID-19 严重型患者中更为明显（均值比 adj = 0.95；95% 置信区间 [CI]，0.90-0.99；P = .02，调整后顺应性差异：-2 mL/cmH2O）：-2 mL/cmH2O）。Alpha1、Alpha2 和 Delta 峰会导致基线呼吸系统顺应性降低，但 Omicron 峰不会（P < .001、P = .02 和 P < .001）。在西班牙裔中，Delta 激增的影响被放大（P-for-Interaction = 0.003；均值比 = 0.83；95% CI，0.74-0.93；P = .001；调整后顺应性差异：-结论：结论：Alpha1、Alpha2 和 Delta 峰期间的 COVID-19 感染史与基线呼吸系统顺应性显著降低有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Anesthesia and analgesia 医学-麻醉学

CiteScore

9.90

自引率

7.00%

发文量

817

审稿时长

2 months

期刊介绍： Anesthesia & Analgesia exists for the benefit of patients under the care of health care professionals engaged in the disciplines broadly related to anesthesiology, perioperative medicine, critical care medicine, and pain medicine. The Journal furthers the care of these patients by reporting the fundamental advances in the science of these clinical disciplines and by documenting the clinical, laboratory, and administrative advances that guide therapy. Anesthesia & Analgesia seeks a balance between definitive clinical and management investigations and outstanding basic scientific reports. The Journal welcomes original manuscripts containing rigorous design and analysis, even if unusual in their approach.