tetano
Editor, Senior Moderator
Chest
. 2021 Mar 4;S0012-3692(21)00464-5.
doi: 10.1016/j.chest.2021.02.062. Online ahead of print.
PULMONARY FUNCTION AND RADIOLOGICAL FEATURES IN SURVIVORS OF CRITICAL COVID-19: A 3-MONTH PROSPECTIVE COHORT
Jessica Gonz?lez[SUP] 1 [/SUP], Iv?n D Ben?tez[SUP] 2 [/SUP], Paola Carmona[SUP] 1 [/SUP], Sally Santisteve[SUP] 1 [/SUP], Aida Monge[SUP] 1 [/SUP], Anna Moncus?-Moix[SUP] 2 [/SUP], Clara Gort-Paniello[SUP] 2 [/SUP], Luc?a Pinilla[SUP] 2 [/SUP], Amara Carratal?[SUP] 2 [/SUP], Mar?a Zuil[SUP] 1 [/SUP], Ricard Ferrer[SUP] 3 [/SUP], Adri?n Ceccato[SUP] 4 [/SUP], Laia Fern?ndez[SUP] 5 [/SUP], Ana Motos[SUP] 5 [/SUP], Jordi Riera[SUP] 3 [/SUP], Rosario Men?ndez[SUP] 6 [/SUP], Dario Garcia-Gasulla[SUP] 7 [/SUP], Oscar Pe?uelas[SUP] 8 [/SUP], Jes?s F Bermejo-Martin[SUP] 9 [/SUP], Gonzalo Labarca[SUP] 10 [/SUP], Jesus Caballero[SUP] 11 [/SUP], Gerard Torres[SUP] 1 [/SUP], David de Gonzalo-Calvo[SUP] 2 [/SUP], Antoni Torres[SUP] 5 [/SUP], Ferran Barb?[SUP] 12 [/SUP], CIBERESUCICOVID Project (COV20/00110, ISCIII)
Affiliations
Abstract
Background: More than 20% of hospitalized patients with coronavirus disease 2019 (COVID-19) develop acute respiratory distress syndrome (ARDS) requiring intensive care unit (ICU) admission. The long-term respiratory sequelae in ICU survivors remain unclear.
Research question: what are the major long-term pulmonary sequelae in critical COVID-19 survivors?
Study design and methods: Consecutive patients with COVID-19 requiring ICU admission were recruited and evaluated 3 months after hospitalization discharge. The follow-up comprised symptom and quality of life, anxiety and depression questionnaires, pulmonary function tests, exercise test (6-minute walking test (6MWT)) and chest computed tomography (CT).
Results: 125 ICU patients with ARDS secondary to COVID-19 were recruited between March and June 2020. At the 3-month follow-up, 62 patients were available for pulmonary evaluation. The most frequent symptoms were dyspnea (46.7%), and cough (34.4%). Eighty-two percent of patients showed a lung diffusing capacity of less than 80%. The median (IQR) distance in the 6MWT was 400 (362;440) meters. CT scans were abnormal in 70.2% of patients, showing reticular lesions in 49.1% and fibrotic patterns in 21.1%. Patients with more severe alterations on chest CT had worse pulmonary function and presented more degrees of desaturation in the 6MWT. Factors associated with the severity of lung damage on chest CT were age and length of invasive mechanical ventilation during the ICU stay.
Interpretation: Pulmonary structural abnormalities and functional impairment are highly prevalent in surviving ICU patients with ARDS secondary to COVID-19 3 months after hospital discharge. Pulmonary evaluation should be considered for all critical COVID-19 survivors 3 months post discharge.
Keywords: COVID-19; CT abnormalities; ICU; SARS; SARS-CoV-2; Sequelae; lung function.
. 2021 Mar 4;S0012-3692(21)00464-5.
doi: 10.1016/j.chest.2021.02.062. Online ahead of print.
PULMONARY FUNCTION AND RADIOLOGICAL FEATURES IN SURVIVORS OF CRITICAL COVID-19: A 3-MONTH PROSPECTIVE COHORT
Jessica Gonz?lez[SUP] 1 [/SUP], Iv?n D Ben?tez[SUP] 2 [/SUP], Paola Carmona[SUP] 1 [/SUP], Sally Santisteve[SUP] 1 [/SUP], Aida Monge[SUP] 1 [/SUP], Anna Moncus?-Moix[SUP] 2 [/SUP], Clara Gort-Paniello[SUP] 2 [/SUP], Luc?a Pinilla[SUP] 2 [/SUP], Amara Carratal?[SUP] 2 [/SUP], Mar?a Zuil[SUP] 1 [/SUP], Ricard Ferrer[SUP] 3 [/SUP], Adri?n Ceccato[SUP] 4 [/SUP], Laia Fern?ndez[SUP] 5 [/SUP], Ana Motos[SUP] 5 [/SUP], Jordi Riera[SUP] 3 [/SUP], Rosario Men?ndez[SUP] 6 [/SUP], Dario Garcia-Gasulla[SUP] 7 [/SUP], Oscar Pe?uelas[SUP] 8 [/SUP], Jes?s F Bermejo-Martin[SUP] 9 [/SUP], Gonzalo Labarca[SUP] 10 [/SUP], Jesus Caballero[SUP] 11 [/SUP], Gerard Torres[SUP] 1 [/SUP], David de Gonzalo-Calvo[SUP] 2 [/SUP], Antoni Torres[SUP] 5 [/SUP], Ferran Barb?[SUP] 12 [/SUP], CIBERESUCICOVID Project (COV20/00110, ISCIII)
Affiliations
- PMID: 33676998
- DOI: 10.1016/j.chest.2021.02.062
Abstract
Background: More than 20% of hospitalized patients with coronavirus disease 2019 (COVID-19) develop acute respiratory distress syndrome (ARDS) requiring intensive care unit (ICU) admission. The long-term respiratory sequelae in ICU survivors remain unclear.
Research question: what are the major long-term pulmonary sequelae in critical COVID-19 survivors?
Study design and methods: Consecutive patients with COVID-19 requiring ICU admission were recruited and evaluated 3 months after hospitalization discharge. The follow-up comprised symptom and quality of life, anxiety and depression questionnaires, pulmonary function tests, exercise test (6-minute walking test (6MWT)) and chest computed tomography (CT).
Results: 125 ICU patients with ARDS secondary to COVID-19 were recruited between March and June 2020. At the 3-month follow-up, 62 patients were available for pulmonary evaluation. The most frequent symptoms were dyspnea (46.7%), and cough (34.4%). Eighty-two percent of patients showed a lung diffusing capacity of less than 80%. The median (IQR) distance in the 6MWT was 400 (362;440) meters. CT scans were abnormal in 70.2% of patients, showing reticular lesions in 49.1% and fibrotic patterns in 21.1%. Patients with more severe alterations on chest CT had worse pulmonary function and presented more degrees of desaturation in the 6MWT. Factors associated with the severity of lung damage on chest CT were age and length of invasive mechanical ventilation during the ICU stay.
Interpretation: Pulmonary structural abnormalities and functional impairment are highly prevalent in surviving ICU patients with ARDS secondary to COVID-19 3 months after hospital discharge. Pulmonary evaluation should be considered for all critical COVID-19 survivors 3 months post discharge.
Keywords: COVID-19; CT abnormalities; ICU; SARS; SARS-CoV-2; Sequelae; lung function.