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Key Factors Associated With Pulmonary Sequelae in the Follow-Up of Critically Ill COVID-19 Patients
Archivos De Bronconeumologia, 2023-04, Vol.59 (4), p.205-215
2023
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Autor(en) / Beteiligte
Titel
Key Factors Associated With Pulmonary Sequelae in the Follow-Up of Critically Ill COVID-19 Patients
Ist Teil von
  • Archivos De Bronconeumologia, 2023-04, Vol.59 (4), p.205-215
Ort / Verlag
Spain: Elsevier España, S.L.U
Erscheinungsjahr
2023
Quelle
MEDLINE
Beschreibungen/Notizen
  • [Display omitted] 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. 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. 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 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 (1.18–2.92)), 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 filtration 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 fibrotic lesions. 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.
Sprache
Englisch; Spanisch
Identifikatoren
ISSN: 0300-2896
eISSN: 1579-2129
DOI: 10.1016/j.arbres.2022.12.017
Titel-ID: cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9824938
Format
–
Schlagworte
COVID-19, COVID-19 - complications, Critical Illness, CT abnormalities, Disease Progression, Female, Follow-Up Studies, Humans, ICU, Lung - diagnostic imaging, Lung function, Male, Middle Aged, Original, Pulmonary Emphysema, Sequelae

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