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Health-related quality of life profiles, trajectories, persistent symptoms and pulmonary function one year after ICU discharge in invasively ventilated COVID-19 patients, a prospective follow-up study.
Gamberini, Lorenzo; Mazzoli, Carlo Alberto; Prediletto, Irene; Sintonen, Harri; Scaramuzzo, Gaetano; Allegri, Davide; Colombo, Davide; Tonetti, Tommaso; Zani, Gianluca; Capozzi, Chiara; Dalpiaz, Giorgia; Agnoletti, Vanni; Cappellini, Iacopo; Melegari, Gabriele; Damiani, Federica; Fusari, Maurizio; Gordini, Giovanni; Laici, Cristiana; Lanza, Maria Concetta; Leo, Mirco; Marudi, Andrea; Papa, Raffaella; Potalivo, Antonella; Montomoli, Jonathan; Taddei, Stefania; Mazzolini, Massimiliano; Ferravante, Anna Filomena; Nicali, Roberta; Ranieri, Vito Marco; Russo, Emanuele; Volta, Carlo Alberto; Spadaro, Savino.
  • Gamberini L; Department of Anaesthesia, Intensive Care and Prehospital Emergency, Ospedale Maggiore Carlo Alberto Pizzardi, Bologna, Italy.
  • Mazzoli CA; Department of Anaesthesia, Intensive Care and Prehospital Emergency, Ospedale Maggiore Carlo Alberto Pizzardi, Bologna, Italy.
  • Prediletto I; Alma Mater Studiorum University of Bologna, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Bologna, Italy; IRCCS Azienda Ospedaliero Universitaria di Bologna, University Hospital Sant'Orsola-Malpighi - Respiratory and Critical Care Unit, Bologna, Italy. Electronic address: ir
  • Sintonen H; Department of Public Health, University of Helsinki, Helsinki, Finland.
  • Scaramuzzo G; Department of Translational Medicine and for Romagna, University of Ferrara, Ferrara, Italy.
  • Allegri D; Department of Clinical Governance and Quality, Bologna Local Healthcare Authority, Bologna, Italy.
  • Colombo D; Anaesthesia and Intensive Care Department - SS. Trinità Hospital, ASL Novara, Italy; Health Science Department - Eastern Piedmont University, Italy.
  • Tonetti T; Alma Mater Studiorum, Dipartimento di Scienze Mediche e Chirurgiche, Anesthesia and Intensive Care Medicine, Policlinico di Sant'Orsola, Università di Bologna, Bologna, Italy.
  • Zani G; Department of Anesthesia and Intensive Care, Santa Maria Delle Croci Hospital, Ravenna, Italy.
  • Capozzi C; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
  • Dalpiaz G; Department of Radiology, Bellaria Hospital, Bologna, Italy.
  • Agnoletti V; Anaesthesia and Intensive Care Unit - M.Bufalini Hospital, Cesena, Italy.
  • Cappellini I; Department of Critical Care Section of Anesthesiology and Intensive Care, Azienda USL Toscana Centro, Prato, Italy.
  • Melegari G; Department of Anaesthesiology, University Hospital of Modena, Via Del Pozzo 71, 41100, Modena, Italy.
  • Damiani F; Department of Anaesthesia, Intensive Care and Pain Therapy - Imola Hospital, Imola, Italy.
  • Fusari M; Department of Anesthesia and Intensive Care, Santa Maria Delle Croci Hospital, Ravenna, Italy.
  • Gordini G; Department of Anaesthesia, Intensive Care and Prehospital Emergency, Ospedale Maggiore Carlo Alberto Pizzardi, Bologna, Italy.
  • Laici C; Postoperative Intensive Care Unit. Medical and Surgical Department of Digestive, Liver and Endocrine-Metabolic Diseases. IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
  • Lanza MC; Department of Anesthesia and Intensive Care, G.B. Morgagni-Pierantoni Hospital, Forlì, Italy.
  • Leo M; Department of Anaesthesia and Intensive Care, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
  • Marudi A; Department of Anaesthesiology, University Hospital of Modena, Via Del Pozzo 71, 41100, Modena, Italy.
  • Papa R; Anaesthesia and Intensive Care Unit, Santa Maria Annunziata Hospital, Firenze, Italy.
  • Potalivo A; Department of Anaesthesia and Intensive Care - Infermi Hospital, Rimini, Italy.
  • Montomoli J; Department of Anaesthesia and Intensive Care - Infermi Hospital, Rimini, Italy.
  • Taddei S; Anaesthesia and Intensive Care Unit, Bentivoglio Hospital, Bentivoglio, Italy.
  • Mazzolini M; Department of Respiratory Medicine, Bellaria Hospital, Bologna, Italy.
  • Ferravante AF; Department of Respiratory Medicine- Infermi Hospital, Rimini, Italy.
  • Nicali R; Outpatient Pneumology Department. - SS. Trinità Hospital Borgomanero, ASL NO, Novara, Italy.
  • Ranieri VM; Alma Mater Studiorum, Dipartimento di Scienze Mediche e Chirurgiche, Anesthesia and Intensive Care Medicine, Policlinico di Sant'Orsola, Università di Bologna, Bologna, Italy.
  • Russo E; Anaesthesia and Intensive Care Unit - M.Bufalini Hospital, Cesena, Italy.
  • Volta CA; Department of Translational Medicine and for Romagna, University of Ferrara, Ferrara, Italy.
  • Spadaro S; Department of Translational Medicine and for Romagna, University of Ferrara, Ferrara, Italy.
Respir Med ; 189: 106665, 2021.
Article in English | MEDLINE | ID: covidwho-1475040
ABSTRACT

BACKGROUND:

Health-related quality of life (HRQoL) impairment is often reported among COVID-19 ICU survivors, and little is known about their long-term outcomes. We evaluated the HRQoL trajectories between 3 months and 1 year after ICU discharge, the factors influencing these trajectories and the presence of clusters of HRQoL profiles in a population of COVID-19 patients who underwent invasive mechanical ventilation (IMV). Moreover, pathophysiological correlations of residual dyspnea were tested.

METHODS:

We followed up 178 survivors from 16 Italian ICUs up to one year after ICU discharge. HRQoL was investigated through the 15D instrument. Available pulmonary function tests (PFTs) and chest CT scans at 1 year were also collected. A linear mixed-effects model was adopted to identify factors associated with different HRQoL trajectories and a two-step cluster analysis was performed to identify HRQoL clusters.

RESULTS:

We found that HRQoL increased during the study period, especially for the significant increase of the physical dimensions, while the mental dimensions and dyspnea remained substantially unchanged. Four main 15D profiles were identified full recovery (47.2%), bad recovery (5.1%) and two partial recovery clusters with mostly physical (9.6%) or mental (38.2%) dimensions affected. Gender, duration of IMV and number of comorbidities significantly influenced HRQoL trajectories. Persistent dyspnea was reported in 58.4% of patients, and weakly, but significantly, correlated with both DLCO and length of IMV.

CONCLUSIONS:

HRQoL impairment is frequent 1 year after ICU discharge, and the lowest recovery is found in the mental dimensions. Persistent dyspnea is often reported and weakly correlated with PFTs alterations. TRIAL REGISTRATION NCT04411459.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Quality of Life / Respiration, Artificial / Respiratory Function Tests / COVID-19 / Intensive Care Units Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Respir Med Year: 2021 Document Type: Article Affiliation country: J.rmed.2021.106665

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Quality of Life / Respiration, Artificial / Respiratory Function Tests / COVID-19 / Intensive Care Units Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Respir Med Year: 2021 Document Type: Article Affiliation country: J.rmed.2021.106665