Pulmonary impairment ‘highly prevalent’ in severe COVID-19 survivors following discharge
Patients with acute respiratory distress syndrome secondary to COVID-19 who required an ICU stay had pulmonary structural abnormalities and lung function impairment at 3 months after discharge, researchers reported.
“Pulmonary structural abnormalities and functional impairment are highly prevalent in patients who survive critical COVID-19 at 3 months after hospital discharge,” Jessica González, MD, from the department of pulmonology at the Arnau de Vilanova University Hospital and Santa Maria in Translational Research at the Respiratory Medicine Group and the Lleida Biomedical Research Institute and the CIBER of Respiratory Diseases in Lleida, Spain, and colleagues wrote in Chest. “A complete evaluation including chest CT imaging and pulmonary function and exercise tests 3 months after discharge should be considered for these survivors of critical COVID-19.”
Researchers evaluated 125 consecutive patients admitted to the ICU with ARDS resulting from COVID-19 infection from March to June 2020. Patients had follow-up examinations 3 months post-hospital discharge, during which symptom and quality of life, anxiety and depression questionnaires, pulmonary function tests, 6-minute walk test and chest CT scans were administered.
At 3 months, 62 patients (mean age, 60 years; 74.2% men) were available for evaluation. The most frequently reported symptoms were dyspnea (46.7%), muscular fatigue (29.5%) and cough (34.4%).
Median 6-minute walk test distance was 400 m. Median length of ICU stay was 14.5 days.
Researchers observed a lung diffusing capacity of less than 80% in 82% of patients. CT scans showed abnormal pulmonary results in 70.2% of patients, with reticular lesions in 49.1% and fibrotic patterns in 21.1%.
Patients with more severe pulmonary alterations on CT scans also had worse pulmonary function and presented with more desaturation in 6-minute walk tests.
Age and length of invasive mechanical ventilation during the patients’ ICU stay were associated with lung damage severity on chest CT scans, according to the results. Patients with longer duration of invasive mechanical ventilation had higher CT scan score and age at time of ICU admission correlated positively with CT scan score (P = .4), according to the results.