Key factors associated with pulmonary sequelae in the follow-up of critically ill COVID-19 patients
Authors
Pérez García, Felipe; González, Jessica; Batlle Garcia, Jordi De; Benítez, Iván D.; Torres, Gerard; [et al.]Identifiers
Permanent link (URI): http://hdl.handle.net/10017/60935DOI: 10.1016/j.arbres.2022.12.017
ISSN: 0300-2896
Date
2023-04-01Funders
Instituto de Salud Carlos III
FEDER
Centro de Investigación Biomédica en Red
Enfermedades Respiratorias
Fundación Francisco Soria Melguizo
Bibliographic citation
Archivos de Bronconeumologia, 2023, v. 59, n. 4, p. 205-215
Keywords
COVID-19
CT abnormalities
ICU
Lung function
Sequelae
Description / Notes
11 p.
Project
info:eu-repo/grantAgreement/ISCIII//CIBERESUCICOVID/ES//
info:eu-repo/grantAgreement/ISCIII//COV20/00110/ES//
info:eu-repo/grantAgreement/ISCIII//CP19/00108/ES//
info:eu-repo/grantAgreement/ISCIII//CP20/00041/ES//
info:eu-repo/grantAgreement/ISCIII//CD21/00087/ES//
Document type
info:eu-repo/semantics/article
Version
info:eu-repo/semantics/acceptedVersion
Rights
Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)
Access rights
info:eu-repo/semantics/openAccess
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-con rmed 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 [p25?p75] time from discharge to follow-up was 3.57 [2.77?4.92] months. Median age was 60 [53?67] 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 in ltrates, brotic 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 (1.18?2.92)), duration of invasive mechanical ventilation (IMV) (OR: 1.56 (1.37?1.77)), age (OR [per-1-SD] (95%CI): 1.39 (1.18?1.63)), urea (OR: 1.16 (0.97?1.39)) and estimated glomerular ltration rate at ICU admission (OR: 0.88 (0.73?1.06)). Bacterial pneumonia (1.62 (1.11?2.35)) and duration of ventilation (NIMV (1.23 (1.06?1.42), IMV (1.21 (1.01?1.45)) and prone positioning (1.17 (0.98?1.39)) were associated with brotic lesions. Conclusion: Age and CLD, re ecting patients? baseline vulnerability, and markers of COVID-19 severity, such as duration of IMV and renal failure, were key factors associated with impaired DLCOand CT abnormalities.
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