Infectious Disease

Pulmonary dysfunction “very common” in severe COVID-19 survivors after discharge

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Patients with acute respiratory distress syndrome as a result of COVID-19 who required a stay in the intensive care unit had structural lung abnormalities and impaired lung function 3 months after discharge, the researchers reported.

“Lung structural abnormalities and functional impairments are very common in patients who survive a critical COVID-19 3 months after discharge from the hospital”, Dr the Respiratory Medicine Group and the Lleida Biomedical Research Institute and the CIBER of Respiratory Diseases in Lleida, Spain, and colleagues wrote in Chest. “For these critical COVID-19 survivors, a full assessment including chest CT imaging and pulmonary function and exercise tests should be considered 3 months after discharge.”

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The researchers evaluated 125 consecutive patients admitted to intensive care with ARDS from March to June 2020 due to COVID-19 infection, function tests, 6-minute walk test, and chest CT scans were performed.

After 3 months, 62 patients (mean age 60 years; 74.2% men) were available for evaluation. The most commonly reported symptoms were dyspnoea (46.7%), muscle fatigue (29.5%), and cough (34.4%).

The mean 6-minute walk test distance was 400 m and the mean length of stay in the intensive care unit was 14.5 days.

Researchers observed a lung diffusion capacity of less than 80% in 82% of patients. CT scans showed abnormal lung results in 70.2% of patients, with reticular lesions in 49.1% and fibrotic patterns in 21.1%.

Patients with more severe lung changes on CT scans also had poorer lung function and showed more desaturation on 6-minute walk tests.

The results showed that the age and duration of invasive mechanical ventilation while patients were in the intensive care unit were associated with the severity of lung damage on chest CT scans. Patients with prolonged invasive mechanical ventilation had a higher CT scan score, and age at the time of ICU admission was positively correlated with the CT scan score (P = 0.4), according to the results.

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