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Cited by 440Long-Term Effects of COVID-19COVID-19 Clinical Research StudiesSARS-CoV-2 and COVID-19 Research

Long-term bone and lung consequences associated with hospital-acquired severe acute respiratory syndrome: a 15-year follow-up from a prospective cohort study

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Zhang, Peixun, Li, Jia, Liu, Huixin, Han, Na, Ju, Jiabao, Kou, Yuhui, Chen, Lei, Jiang, Mengxi +4 more·2020·Bone Research
DOI 10.1038/s41413-020-0084-5PMC PMC7018717
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Abstract

The most severe sequelae after rehabilitation from SARS are femoral head necrosis and pulmonary fibrosis. We performed a 15-year follow-up on the lung and bone conditions of SARS patients. We evaluated the recovery from lung damage and femoral head necrosis in an observational cohort study of SARS patients using pulmonary CT scans, hip joint MRI examinations, pulmonary function tests and hip joint function questionnaires. Eighty medical staff contracted SARS in 2003. Two patients died of SARS, and 78 were enrolled in this study from August 2003 to March 2018. Seventy-one patients completed the 15-year follow-up. The percentage of pulmonary lesions on CT scans diminished from 2003 (9.40 ± 7.83)% to 2004 (3.20 ± 4.78)% (P < 0.001) and remained stable thereafter until 2018 (4.60 ± 6.37)%. Between 2006 and 2018, the proportion of patients with interstitial changes who had improved pulmonary function was lower than that of patients without lesions, as demonstrated by the one-second ratio (FEV 1/FVC%, t = 2.21, P = 0.04) and mid-flow of maximum expiration (FEF 25%–75%, t = 2.76, P = 0.01). The volume of femoral head necrosis decreased significantly from 2003 (38.83 ± 21.01)% to 2005 (30.38 ± 20.23)% (P = 0.000 2), then declined slowly from 2005 to 2013 (28.99 ± 20.59)% and plateaued until 2018 (25.52 ± 15.51)%. Pulmonary interstitial damage and functional decline caused by SARS mostly recovered, with a greater extent of recovery within 2 years after rehabilitation. Femoral head necrosis induced by large doses of steroid pulse therapy in SARS patients was not progressive and was partially reversible.

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  1. [25]Hongyu, W. Three Dimensional digitalized visualization of necrotic volume distribution and morphology and collapse identification on ONFH. Peking Union Medical University graduate thesis (2009).

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Authors
Zhang, P., Li, J., Liu, H., Han, N., Ju, J., Kou, Y., Chen, L., Jiang, M., Pan, F., Zheng, Y., Gao, Z., & Jiang, B.
Affiliations
Peking University People's Hospital (CN)
Corresponding author
  • Gao, Zhancheng
  • Jiang, Baoguo
ORCID
Venue
Bone Research
Publisher
Springer Science and Business Media LLC
Published
2020-02-14
Volume
8
Issue
1
Pages
8-8
ISSN
  • 2095-4700 (ISSN-L)
  • 2095-6231
DOI
10.1038/s41413-020-0084-5
PMC
PMC7018717
OpenAlex
W3006317414
Cited by
440
References
27
Citations by year
2026: 7 · 2025: 24 · 2024: 35 · 2023: 51 · 2022: 95 · 2021: 151 · 2020: 74 · 2015: 1
FWCI
40.16
Type
journal article
Language
en
Update notices
correction (2020-09-21)
Open access
Licence
Locations
  • Bone Research (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Informationszentrum Lebenswissenschaften (ZB MED) (submittedVersion, cc-by)
Funders
  • Peking University
  • Peking University People's Hospital (31771322, 31571235)
  • Peking University Health Science Center
Topics
  • Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
  • Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
  • Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
Keywords
SARS, osteonecrosis of the femoral head, pulmonary fibrosis, long-term follow-up, rehabilitation, steroid pulse therapy, healthcare workers, lung CT, lung function

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