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Residual lung damage following ARDS in COVID-19 ICU survivors
- Source :
- Acta Anaesthesiologica Scandinavica
- Publication Year :
- 2022
- Publisher :
- John Wiley and Sons Inc, 2022.
-
Abstract
- Background Coronavirus disease 2019 acute respiratory distress syndrome (COVID‐19 ARDS) is a disease that often requires invasive ventilation. Little is known about COVID‐19 ARDS sequelae. We assessed the mid‐term lung status of COVID‐19 survivors and investigated factors associated with pulmonary sequelae. Methods All adult COVID‐19 patients admitted to the intensive care unit from 25th February to 27th April 2020 were included. Lung function was evaluated through chest CT scan and pulmonary function tests (PFT). Logistic regression was used to identify predictors of persisting lung alterations. Results Forty‐nine patients (75%) completed lung assessment. Chest CT scan was performed after a median (interquartile range) time of 97 (89–105) days, whilst PFT after 142 (133–160) days. The median age was 58 (52–65) years and most patients were male (90%). The median duration of mechanical ventilation was 11 (6–16) days. Median tidal volume/ideal body weight (TV/IBW) was 6.8 (5.71–7.67) ml/Kg. 59% and 63% of patients showed radiological and functional lung sequelae, respectively. The diffusion capacity of carbon monoxide (DLCO) was reduced by 59%, with a median per cent of predicted DLCO of 72.1 (57.9–93.9) %. Mean TV/IBW during invasive ventilation emerged as an independent predictor of persistent CT scan abnormalities, whilst the duration of mechanical ventilation was an independent predictor of both CT and PFT abnormalities. The extension of lung involvement at hospital admission (evaluated through Radiographic Assessment of Lung Edema, RALE score) independently predicted the risk of persistent alterations in PFTs. Conclusions Both the extent of lung parenchymal involvement and mechanical ventilation protocols predict morphological and functional lung abnormalities months after COVID‐19.
- Subjects :
- Adult
Male
ARDS
chest CT scan
medicine.medical_treatment
critically ill patients
pulmonary function tests
Pulmonary function testing
COVID‐19
Interquartile range
DLCO
Intensive care
follow-up
Medicine
Humans
Survivors
Lung
Research Articles
Tidal volume
intensive care
follow‐up
Mechanical ventilation
Respiratory Distress Syndrome
pulmonary fibrosis
business.industry
SARS-CoV-2
COVID-19
General Medicine
respiratory system
acute respiratory distress syndrome
Middle Aged
medicine.disease
respiratory tract diseases
Intensive Care Units
Anesthesiology and Pain Medicine
medicine.anatomical_structure
Anesthesia
business
Research Article
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Acta Anaesthesiologica Scandinavica
- Accession number :
- edsair.doi.dedup.....770c82636f45591ef1873091592468ca