Objective

2

To analyze the traditional Chinese medicine （TCM） symptoms and syndrome distribution characteristics of patients with post-acute COVID-19 interstitial lung disease （PC-ILD） and explore the pathogenesis and disease evolution.

Methods

2

A total of 103 patients diagnosed with PC-ILD from February 2023 to June 2024 at the outpatient and inpatient departments of Beijing Hospital of Traditional Chinese Medicine， Capital Medical University， were enrolled. Their medical information， including data from the four diagnostic methods and syndrome differentiation， was retrospectively analyzed.

Results

2

Among the 103 patients， 20 symptoms were recorded， with pulmonary symptoms being the most common. Compared to patients with acute COVID-19 whose disease duration was ≥3 months， those with a disease duration of

<

3 months had a higher proportion of thirst， half-body sweating， bitter taste， difficulty swallowing， and sticky mouth （

P

<

0.05）， and a lower proportion of aversion to cold and waist/knee soreness （

P

<

0.05）. Compared to mild and moderate COVID-19 patients， severe and critical patients had a higher proportion of shortness of breath， wheezing， fatigue， and night sweating （

P

<

0.05）. Compared to patients without underlying ILD， those with underlying ILD had a higher proportion of shortness of breath， wheezing， fatigue， lumbar and knee soreness， and aversion to cold （

P

<

0.05）. Among the 103 patients， there were 4 types of tongue texture， 5 types of tongue coating， and 6 types of pulse. Compared to patients with acute COVID-19 whose disease duration was ≥3 months， those with a disease duration of

<

3 months had a higher proportion of yellow

greasy coating， slippery pulse， thready pulse， and soggy pulse （

P

<

0.05）. Compared to mild and moderate COVID-19 patients， severe and critical patients had a higher proportion of thready pulse （

P

<

0.05）. Compared to patients without ILD， those with underlying ILD had a higher proportion of deep pulse and thready pulse （

P

<

0.05）. Among the 103 patients， 79 （76.7%） had a mixed deficiency and excess syndrome， 14 （13.6%） had an excess syndrome， and 10 （9.7%） had a deficiency syndrome. There were a total of 13 types of syndromes. Compared to patients with acute COVID-19 whose disease duration was ≥3 months， those with a disease duration of

<

3 months had a higher proportion of lung

yin

deficiency， kidney

yin

deficiency， dampness-heat accumulation， and

Shaoyang

depression syndrome （

P

<

0.05）， and a lower proportion of kidney

yang

deficiency （

P

<

0.05）. Compared to mild and moderate COVID-19 patients， severe and critical patients had a higher proportion of lung

qi

deficiency， lung

yin

deficiency， and kidney

yin

deficiency （

P

<

0.05）. Compared to patients without ILD， those with ILD had a higher proportion of kidney

qi

deficiency and kidney

yang

deficiency （

P

<

0.05）. The overall disease distribution among the 103 patients was primarily in the lungs.

Conclusion

2

The clinical TCM symptoms of PC-ILD are mainly pulmonary symptoms. The pathogenesis involves both deficiency of healthy

qi

（lung

qi

deficiency） and excess pathogenic factors （turbidity-phlegm and dampness-stasis）. The disease primarily affects the

Taiyin

lung， with severe/critical COVID-19 patients and those with underlying ILD more likely to involve the

Shaoyin

kidney.