Six Months Follow-Up of Patients with Invasive Mechanical Ventilation Due to COVID-19 Related ARDS

Abstract

Although patients who recovered from acute coronavirus disease 2019 (COVID-19) may have prolonged disabilities, follow-up data of those who have survived COVID-19 related acute respiratory distress syndrome (ARDS) is still very scarce. Therefore, COVID-19-ARDS survivors requiring invasive mechanical ventilation (IMV) were followed six months after discharge. Pulmonary function tests (PFTs), 6-min walk test (6MWT) and echocardiography were performed. Quality of life (QoL), depression and anxiety were assessed using validated questionnaires. Patients were compared based on respiratory mechanics and CT-phenotype during intensive care unit (ICU) stay. Eighteen patients were included (61 ± 7 years; ICU-stay: 34 ± 16 days; IMV: 30 ± 15 days). At follow-up (197 ± 15 days after discharge), PFTs did not reveal significant limitations (VC: 92 ± 16%; FEV1: 92 ± 20%; DLco/VA: 81 ± 16%). Cardiac systolic function was normal in all patients, but 50% of them had diastolic dysfunction. 6MWT was under the lower limit of normal in only two patients. Eight patients (44%) reported tiredness, six (33%) suffered from fatigue and one patient (6%) had depression and anxiety. Surprisingly, patients with worse respiratory mechanics during IMV reported fewer symptoms and less exertional dyspnea at follow-up. In conclusion, patients with COVID-19-ARDS have the possibility to fully recover regarding pulmonary function and exercise capacity, which seems to be independent of disease severity during ICU stay.

Health-related quality of life profiles, trajectories, persistent symptoms and pulmonary function one year after ICU discharge in invasively ventilated COVID-19 patients, a prospective follow-up study

“…On the other hand, in our study population DLCO impairment degree, which is the most reported respiratory functional impairment in post-COVID syndrome, was not associated with ARDS severity. Even if potentially controversial, this result confirms that COVID-19 patients requiring intensive care and IMV can fully recover [32,33].…”

Cardiopulmonary work up of patients with and without fatigue 6 months after COVID-19

“…Many previous studies have shown that lung function tends to normalize in patients recovering from COVID-19 [23], even in those who experienced a severe disease and required to be mechanically ventilated [34]. Our data also con rmed these results in both groups of patients, with and without fatigue.…”

Morphologische und funktionelle Folgen nach COVID-19-Pneumonie

“…50 % der zu Hause isolierten jungen Erwachsenen im Alter von 16-30 Jahren 6 Monate nach der Infektion über Symptome wie Müdigkeit (21 %) und Dyspnoe (13 %; [3]). Bei Patienten nach einem COVID-19-ARDS ("acute respiratory distress syndrome", Atemnotsyndrom des Erwachsenen) waren die häufigsten Symptome nach 6 Monaten Müdigkeit (44 %) und Abgeschlagenheit (33 %), während respiratorische Symptome wie Dyspnoe und Husten weniger häufig berichtet wurden (18 und 17 %; [8]). Der 6-Minuten-Gehtest lag in dieser Studie nur bei 2 Patienten (11 %) unter der unteren Normgrenze [8].…”

“…Bei Patienten nach einem COVID-19-ARDS ("acute respiratory distress syndrome", Atemnotsyndrom des Erwachsenen) waren die häufigsten Symptome nach 6 Monaten Müdigkeit (44 %) und Abgeschlagenheit (33 %), während respiratorische Symptome wie Dyspnoe und Husten weniger häufig berichtet wurden (18 und 17 %; [8]). Der 6-Minuten-Gehtest lag in dieser Studie nur bei 2 Patienten (11 %) unter der unteren Normgrenze [8]. Bei keinem Patienten gab es einen signifikanten Abfall der Sauerstoffsättigung nach Belastung [8].…”

“…Der 6-Minuten-Gehtest lag in dieser Studie nur bei 2 Patienten (11 %) unter der unteren Normgrenze [8]. Bei keinem Patienten gab es einen signifikanten Abfall der Sauerstoffsättigung nach Belastung [8]. Insgesamt wurde mit der Zeit eine deutliche und kontinuierliche Verbesserung aller Symptome (Beeinträchtigung der körperlichen Leistungsfähigkeit, Dyspnoe, Husten usw.)…”