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Post severe COVID-19 infection lung damages study. The experience of early three months multidisciplinary follow-up.
De Michele, Lucrezia; Pierucci, Paola; Giovannetti, Guido; De Ceglie, Michele; Dimitri, Michela; Mirabile, Alessandra; Quaranta, Vitaliano; Scardapane, Arnaldo; D'Agostino, Carlo; Carpagnano, Giovanna Elisiana.
  • De Michele L; Cardio Thoracic and Vascular Department, University Hospital Policlinic of Bari. lucreziademichele@libero.it.
  • Pierucci P; Cardiothoracic Department, Respiratory and Critical Care Unit, Bari Policlinic University Hospital, Bari; Section of Respiratory Diseases, Department of Basic Medical Science Neuroscience and Sense Organs, University of Bari 'Aldo Moro', Bari. paola.pierucci@policlinico.ba.it.
  • Giovannetti G; Department of Biomedical Sciences and Human Oncology, University of Bari 'Aldo Moro' Medical School, Bari . guidogiovannettijr@gmail.com.
  • De Ceglie M; DIM, Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, University of Bari 'Aldo Moro' Medical School, Bari . micheledeceglie@libero.it.
  • Dimitri M; Section of Respiratory Diseases, Department of Basic Medical Science Neuroscience and Sense Organs, University of Bari 'Aldo Moro', Bari. michela.dimitri88@gmail.com.
  • Mirabile A; DIM, Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, University of Bari 'Aldo Moro' Medical School, Bari . alemira7@gmail.com.
  • Quaranta V; Respiratory Unit, Di Venere Hospital, Bari. vitalianonicola.40@gmail.com.
  • Scardapane A; DIM, Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, University of Bari 'Aldo Moro' Medical School, Bari. arnaldo.scardapane@gmail.com.
  • D'Agostino C; DIM, Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, University of Bari 'Aldo Moro' Medical School, Bari. carlo.dagostino@policlinico.ba.it.
  • Carpagnano GE; Cardiothoracic Department, Respiratory and Critical Care Unit, Bari Policlinic University Hospital, Bari. elisiana.carpagnano@uniba.it.
Monaldi Arch Chest Dis ; 92(4)2022 Jan 19.
Article in English | MEDLINE | ID: covidwho-1631582
ABSTRACT
The correct type and time of follow-up for patients affected by COVID19 ARDS is still unclear. The aim of this study was to evaluate at the survivors to COVID19 ARDS requiring non-invasive respiratory support (NRS) admitted to a Respiratory Intensive care unit (RICU) from March 8th till May 31th 2020 looking at all sequelae via a comprehensive follow up. All patients underwent a multi-disciplinary instrumental and clinical assessment within three months form admission to evaluate all infection related sequelae. Thirty-eight patients were enrolled Lung-Ultrasound (LUS) showed an outstanding discrimination ability (ROC AUC 0.95) and a substantial agreement rate (Cohen's K 0.74) compared to chest CT-scan detecting improvement of lung consolidations. Youden's test showed a cut-off pressure of 11 cmH2O ExpiratoryPAP-Continuous-PAP-max (EPAP-CPAP) applied at the airways during hospitalization to be significantly correlated (p value 0.026) to the increased pulmonary artery common trunk diameter. A total of 8/38 patients (21.8%), 2 of whom during follow-up, were diagnosed with Pulmonary Emboli (PE) and started anticoagulant treatment. Patients with PE had a statistically significant shorter length of time of hospitalization, time to negative swab, CPAP/NIV duration, P/F ratio and D-dimers at follow-up compared to non PE. A comprehensive approach to patients with ARDS COVID19 requiring NRS is necessary. This study highlighted cardiopulmonary impairment related to the ARDS and to the high-EPAP-CPAP-max greater than 11mmHg provided during admission, the usefulness of LUS in monitoring post-infection recovery and the correct identification and  treatment of patients with PE during follow up.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Distress Syndrome / COVID-19 Type of study: Cohort study / Experimental Studies / Prognostic study Topics: Long Covid Limits: Humans Language: English Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Distress Syndrome / COVID-19 Type of study: Cohort study / Experimental Studies / Prognostic study Topics: Long Covid Limits: Humans Language: English Year: 2022 Document Type: Article