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

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MDPI
DOI: 10.3390/ijerph18115861

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coronavirus; critical illness; follow-up; pulmonary function; fatigue; depression; anxiety; quality of life

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COVID-19-ARDS patients have the potential for full recovery in terms of pulmonary function and exercise capacity six months after discharge, regardless of disease severity during ICU stay.
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.

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