[Prognostic analysis of lung function and chest X-ray changes of 258 patients with severe acute respiratory syndrome in rehabilitation after discharge].

OBJECTIVE: To analyze the clinical characteristics and prognostic changes of rehabilitating severe acute respiratory syndrome (SARS) patients through regular lung function tests and lung imaging studies after discharge and to retrospectively analyze the treatment data of these patients. METHODS: 258 discharged SARS patients received regular SARS-Co virus IgG test, lung function test and chest X-ray and/or high resolution computerized tomography (HRCT) examination at General Hospital of PLA two months after discharge, and the treatment data of these patients were retrospectively analyzed. RESULTS: 80.6% patients (208 of 258 patients) were positive for SARS-Co virus IgG. 21.3% patients (55 of 258 patients) showed lung diffusion abnormity (D(LCO) < 80%pred). Compared to 155 SARS-Co virus IgG positive patients without lung diffusion abnormity and 50 SARS-Co virus IgG negative patients, the 53 SARS-Co virus IgG positive patients with lung diffusion abnormity had longer fever course, higher dosages of glucocorticoid therapy, higher percentage of oxygen therapy and non-invasive ventilation. 51 of the 53 patients with lung diffusion abnormity received lung function test after one month, and the results of D(LCO) improved in 80.4% patients (41 of 51 patients). 40 of 51 patients with lung diffusion abnormity showed lung fibrosis, and the fibrosis decreased in 55% patients (22 of 40 patients) after one month. CONCLUSIONS: This finding suggests that lung fibrosis caused by SARS mostly occurs in severe patients, and it can resolve spontaneously. D(LCO) may be more sensitive than HRCT in evaluating the fibrotic changes.