ABSTRACT
Introduction: We don't known whether pharmacological treatments and adaptation of ventilatory support has changed the outcomes of intensive care unit (ICU) COVID-19 survivors during the consecutive waves (W) of the pandemics. Aims and objectives: To assess pulmonary functional outcomes, radiologic pattern and quality of life (QoL) in ICU COVID-19 survivors at 3 months, according to W of pandemics. Method(s): Patients admitted to ICU for COVID-19 acute respiratory distress syndrome (ARDS) in 2 university hospitals were prospectively included, and assessed 3 months post discharge by a chest CT Scan, pulmonary function test (PFT), 6-minute walking distance test (6MWDT), respiratory muscle strength (RMS), and Short Form 36 (SF-36) questionnaire. Result(s): 84 ARDS COVID -19 survivors were included. Hospital length of stay was shorter during W3 vs W1 (23.4 +/- 14.2 vs 34.7 +/- 20.8, p= 0.03). Less patients required mechanical ventilation (MV) during W2 vs W1 (33.3 % vs 63.9%, p=0.0038). Three months after discharge, PFT, 6MWDT and RMS were similar, regardless the W (p>0.05). QoL (SF-36) was worse for patients of W1 vs W3 (64.7+/- 16.3 vs 49.2 +/- 23.2, p= 0.0169). On multivariate analysis, MV was associated with decreased total lung capacity (TLC), forced expiratory volume in 1 sec (FEV1), diffusing capacity of CO (DLCO) and RMS (w1,2,3, p<0.05). Low SF-36 score was correlated with low 6MWDT (w3, p= 0.01). Glucocorticoids use was associated with better PFT and chest CT recovery (p=0.00001), and tocilizumab with higher TLC (w1, p=0.03). Remdesevir improved MV duration in w2 (p=0.008). Conclusions At 3 months, PFT remains similar in ICU survivors, regardless pandemic w.
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