ABSTRACT
Research Questions: To describe the prevalence of radiological sequelae, 1 year after admission, of patients with pneumonia and adult respiratory distress syndrome (ARDS) due to SARS-CoV-2 and avaluate their relationship with ventilatory support and/or corticosteroids (CC) Material(s) and Method(s): Observational study of patients with pneumonia and ARDS due to SARS-CoV-2 who required admission to the ICU/IRCU of Granollers Hospital between March and May 2020. We collect clinical and radiological data, the treatment received (ventilatory support and CC) and radiological features (thoracic CT) at 12 months Results: Of a total of 109 admitted patients, 23 died during hospital stay. 78 patients were followed up. 69% were men;mean age 61 (+/-11) years. 49% required invasive ventilation (IV), 27% non-invasive positive pressure support (NIV), and 24% high-flow nasal cannula oxygen therapy (HFNC). 66% received CC therapy Of the 71 patients who were followed up at year, 31% presented normal radiology, 7% ground glass opacities, 53.5% reticulum and 8.5% fibrosis. In relation to residual/fibrotic sequelae, a higher proportion was observed in >60 years (73.9% vs 40%;p=0.005) and in patients who required IV, compared to NIV and HFNC (73.5% vs 61.9 vs 37.5%;p=0.05), with no significant differences in the use of CC (72.1% vs 55.6%;p=0.156) In the multivariate analysis, age (>60 years) and invasive ventilation were associated with the presence of pulmonary sequelae (OR 3.92 [95% CI 1.31-11.75]) and (OR 3.85 [95% CI 1.01-14.64]) Conclusion(s): 8.5% of patients presented pulmonary fibrosi at 1 year. Age (>60) years and invasive ventilation were related to a higher frequency of pulmonary radiological sequelae, regardless of administration of CC.
ABSTRACT
Research Questions: To describe lung function at 12-18 months in patients with pneumonia and adult respiratory distress syndrome (ARDS) due to SARS-CoV2 with radiological sequelae Material(s) and Method(s): Observational study of patients with pneumonia and ARDS due to SARS-CoV2 who required admission to the ICU/IRCU of Granollers Hospital between March and May 2020. We collected clinical, chest CT, spirometry and DLCO data. The dyspnoea is defined according to the modified Medical Research Council (mMRC) scale, an altered spirometry is considered when FVC and/or FEV1<80%, and the presence of a reticular patern/fibrosis is valued as radiological sequelae Results: Of a total of 109 admitted patients, 23 died during hospital stay. Of the survivors, 71 patients were followed up in outpatient clinics after 1 year. Of these, 44 presented radiological sequelae on chest CT at 1 year after discharge (6, pulmonary fibrosis). 70.5% were men, mean age of 63.8 (+/-9.08) years and 56.8% with smoking history At 1 year, 39% had MMRC dyspnoea grade 0, 43.9% grade 1, and 17.1% grade 2 or 3 32.5% had normal spirometry and DLCO>80%, 35% normal spirometry and DLCO<80%, and 17.5% altered spirometry and DLCO<80%. 42.5% had a DLCO between 60-79% and 10% between 40-59% We observed that 53.3% of patients with dyspnoea grade 0 and 54.2% of patients with dyspnoea grade >1 had DLCO<80% [p= 0'959] and that 75% of patients with fibrosis and 50% of patients with reticular pattern had DLCO<80% At 18 months, a drop in DLCO>15% was observed in 3/30 patients (10%) Conclusion(s): At 1 year, 32.5% of patients had normal Spirometry and DLCO>80%. No relationship was observed between degree of dyspnoea and DLCO. No significant drop in DLCO was regarded at 18 months .