Key Factors Associated With Pulmonary Sequelae in the Follow-Up of Critically Ill COVID-19 Patients
Arch. bronconeumol. (Ed. impr.)
; 59(4): 205-215, abr. 2023. ilus, tab, graf
Artigo
em Inglês
| IBECS
| ID: ibc-218662
Biblioteca responsável:
ES1.1
Localização: ES15.1 - BNCS
ABSTRACT
Introduction:
Critical COVID-19 survivors have a high risk of respiratory sequelae. Therefore, we aimed to identify key factors associated with altered lung function and CT scan abnormalities at a follow-up visit in a cohort of critical COVID-19 survivors.Methods:
Multicenter ambispective observational study in 52 Spanish intensive care units. Up to 1327 PCR-confirmed critical COVID-19 patients had sociodemographic, anthropometric, comorbidity and lifestyle characteristics collected at hospital admission; clinical and biological parameters throughout hospital stay; and, lung function and CT scan at a follow-up visit.Results:
The median [p25p75] time from discharge to follow-up was 3.57 [2.774.92] months. Median age was 60 [5367] years, 27.8% women. The mean (SD) percentage of predicted diffusing lung capacity for carbon monoxide (DLCO) at follow-up was 72.02 (18.33)% predicted, with 66% of patients having DLCO<80% and 24% having DLCO<60%. CT scan showed persistent pulmonary infiltrates, fibrotic lesions, and emphysema in 33%, 25% and 6% of patients, respectively. Key variables associated with DLCO<60% were chronic lung disease (CLD) (OR 1.86 (1.182.92)), duration of invasive mechanical ventilation (IMV) (OR 1.56 (1.371.77)), age (OR [per-1-SD] (95%CI) 1.39 (1.181.63)), urea (OR 1.16 (0.971.39)) and estimated glomerular filtration rate at ICU admission (OR 0.88 (0.731.06)). Bacterial pneumonia (1.62 (1.112.35)) and duration of ventilation (NIMV (1.23 (1.061.42), IMV (1.21 (1.011.45)) and prone positioning (1.17 (0.981.39)) were associated with fibrotic lesions.Conclusion:
Age and CLD, reflecting patients baseline vulnerability, and markers of COVID-19 severity, such as duration of IMV and renal failure, were key factors associated with impaired DLCO and CT abnormalities. (AU)
Texto completo:
Disponível
Coleções:
Bases de dados nacionais
/
Espanha
Base de dados:
IBECS
Assunto principal:
Enfisema Pulmonar
/
Infecções por Coronavirus
/
Pandemias
Limite:
Idoso
/
Feminino
/
Humanos
/
Masculino
País/Região como assunto:
Europa
Idioma:
Inglês
Revista:
Arch. bronconeumol. (Ed. impr.)
Ano de publicação:
2023
Tipo de documento:
Artigo
Instituição/País de afiliação:
University Hospital Arnau de Vilanova and Santa Maria/Spain