tetano
Editor, Senior Moderator
J Cardiothorac Vasc Anesth
. 2021 Nov 27;S1053-0770(21)01036-3.
doi: 10.1053/j.jvca.2021.11.032. Online ahead of print.
One-Year Multidisciplinary Follow-Up of Patients With COVID-19 Requiring Invasive Mechanical Ventilation
Alberto Zangrillo[SUP] 1 [/SUP], Alessandro Belletti[SUP] 2 [/SUP], Diego Palumbo[SUP] 3 [/SUP], Maria Rosa Calvi[SUP] 2 [/SUP], Francesca Guzzo[SUP] 2 [/SUP], Evgeny V Fominskiy[SUP] 2 [/SUP], Alessandro Ortalda[SUP] 2 [/SUP], Pasquale Nardelli[SUP] 2 [/SUP], Marco Ripa[SUP] 4 [/SUP], Martina Baiardo Redaelli[SUP] 2 [/SUP], Giovanni Borghi[SUP] 2 [/SUP], Giovanni Landoni[SUP] 5 [/SUP], Filippo D'Amico[SUP] 2 [/SUP], Marilena Marmiere[SUP] 2 [/SUP], Beatrice Righetti[SUP] 2 [/SUP], Margherita Rocchi[SUP] 2 [/SUP], Marco Saracino[SUP] 2 [/SUP], Moreno Tresoldi[SUP] 6 [/SUP], Lorenzo Dagna[SUP] 7 [/SUP], Francesco De Cobelli[SUP] 8 [/SUP], COVID-BioB Study Group
Affiliations
Abstract
Objectives: Patients with COVID-19 frequently develop acute respiratory distress syndrome (ARDS) requiring intensive care unit (ICU) admission. Data on long-term survival of these patients are lacking. The authors investigated 1-year survival, quality of life, and functional recovery of patients with COVID-19 ARDS requiring invasive mechanical ventilation.
Design: Prospective observational study.
Setting: Tertiary-care university hospital.
Participants: All patients with COVID-19 ARDS receiving invasive mechanical ventilation and discharged alive from hospital.
Interventions: Patients were contacted by phone after 1 year. Functional, cognitive, and psychological outcomes were explored through a questionnaire and assessed using validated scales. Patients were offered the possibility to undergo a follow-up chest computed tomography (CT) scan.
Measurements and main results: The study included all adult (age ≥18 years) patients with COVID-19-related ARDS admitted to an ICU of the authors' institution between February 25, 2020, and April 27, 2020, who received at least 1 day of invasive mechanical ventilation (IMV). Of 116 patients who received IMV, 61 (52.6%) survived to hospital discharge. These survivors were assessed 1 year after discharge and 56 completed a battery of tests of cognition, activities of daily living, and interaction with family members. They had overall good functional recovery, with >80% reporting good recovery and no difficulties in usual activities. A total of 52 (93%) of patients had no dyspnea at rest. Severe anxiety/depression was reported by 5 (8.9%) patients. Comparing 2-month and 1-year data, the authors observed the most significant improvements in the areas of working status and exertional dyspnea. One-year chest CT scans were available for 36 patients; fibrotic-like changes were present in 4 patients.
Conclusions: All patients who survived the acute phase of COVID-19 and were discharged from the hospital were alive at the 1-year follow up, and the vast majority of them had good overall recovery and quality of life.
Keywords: acute respiratory distress syndrome; coronavirus disease 2019; intensive care unit; lung recovery; post-intensive care syndrome; pulmonary fibrosis; quality of life.
. 2021 Nov 27;S1053-0770(21)01036-3.
doi: 10.1053/j.jvca.2021.11.032. Online ahead of print.
One-Year Multidisciplinary Follow-Up of Patients With COVID-19 Requiring Invasive Mechanical Ventilation
Alberto Zangrillo[SUP] 1 [/SUP], Alessandro Belletti[SUP] 2 [/SUP], Diego Palumbo[SUP] 3 [/SUP], Maria Rosa Calvi[SUP] 2 [/SUP], Francesca Guzzo[SUP] 2 [/SUP], Evgeny V Fominskiy[SUP] 2 [/SUP], Alessandro Ortalda[SUP] 2 [/SUP], Pasquale Nardelli[SUP] 2 [/SUP], Marco Ripa[SUP] 4 [/SUP], Martina Baiardo Redaelli[SUP] 2 [/SUP], Giovanni Borghi[SUP] 2 [/SUP], Giovanni Landoni[SUP] 5 [/SUP], Filippo D'Amico[SUP] 2 [/SUP], Marilena Marmiere[SUP] 2 [/SUP], Beatrice Righetti[SUP] 2 [/SUP], Margherita Rocchi[SUP] 2 [/SUP], Marco Saracino[SUP] 2 [/SUP], Moreno Tresoldi[SUP] 6 [/SUP], Lorenzo Dagna[SUP] 7 [/SUP], Francesco De Cobelli[SUP] 8 [/SUP], COVID-BioB Study Group
Affiliations
- PMID: 34973891
- DOI: 10.1053/j.jvca.2021.11.032
Abstract
Objectives: Patients with COVID-19 frequently develop acute respiratory distress syndrome (ARDS) requiring intensive care unit (ICU) admission. Data on long-term survival of these patients are lacking. The authors investigated 1-year survival, quality of life, and functional recovery of patients with COVID-19 ARDS requiring invasive mechanical ventilation.
Design: Prospective observational study.
Setting: Tertiary-care university hospital.
Participants: All patients with COVID-19 ARDS receiving invasive mechanical ventilation and discharged alive from hospital.
Interventions: Patients were contacted by phone after 1 year. Functional, cognitive, and psychological outcomes were explored through a questionnaire and assessed using validated scales. Patients were offered the possibility to undergo a follow-up chest computed tomography (CT) scan.
Measurements and main results: The study included all adult (age ≥18 years) patients with COVID-19-related ARDS admitted to an ICU of the authors' institution between February 25, 2020, and April 27, 2020, who received at least 1 day of invasive mechanical ventilation (IMV). Of 116 patients who received IMV, 61 (52.6%) survived to hospital discharge. These survivors were assessed 1 year after discharge and 56 completed a battery of tests of cognition, activities of daily living, and interaction with family members. They had overall good functional recovery, with >80% reporting good recovery and no difficulties in usual activities. A total of 52 (93%) of patients had no dyspnea at rest. Severe anxiety/depression was reported by 5 (8.9%) patients. Comparing 2-month and 1-year data, the authors observed the most significant improvements in the areas of working status and exertional dyspnea. One-year chest CT scans were available for 36 patients; fibrotic-like changes were present in 4 patients.
Conclusions: All patients who survived the acute phase of COVID-19 and were discharged from the hospital were alive at the 1-year follow up, and the vast majority of them had good overall recovery and quality of life.
Keywords: acute respiratory distress syndrome; coronavirus disease 2019; intensive care unit; lung recovery; post-intensive care syndrome; pulmonary fibrosis; quality of life.
