Severe COVID-19 pneumonia: clinical, functional, and imaging outcomes at 4 months

Given the pathophysiology of coronavirus disease 19 (COVID-19), persistent pulmonary abnormalities are feared.We conducted a French prospective cohort study in severe COVID-19 patients who had oxygen saturation <94% and were admitted to hospital. We primarily aimed to describe persistent gas exchange abnormalities at 4 months, defined as decreased diffusing capacity of the lungs for carbon monoxide (DLco) and/or desaturation on the 6-minute walk test (6MWT), along with the associated mechanisms and risk factors.Of the 72 patients included, 76.1% required admission to the intensive care unit (ICU), while 68.5% required invasive mechanical ventilation (MV). Some 39.1% developed venous thromboembolism (VTE). At 4 months, 61.4% were still symptomatic. On a functional level, 39.1% had abnormal carbon monoxide test results and/or desaturation on the 6MWT. High-flow oxygen, MV, and VTE during the acute phase were significantly associated with these abnormalities. Restrictive lung disease was observed in 23.6% of cases, obstructive lung disease in 16.7%, and respiratory muscle dysfunction in 18.1%. The severity on initial presentation with admission to the ICU and VTE occurrence during the acute phase were associated with these abnormalities. On CT, 41% had interstitial lung disease. Four patients (5.5%) displayed residual defects on lung scintigraphy, only one of whom had developed VTE during the acute phase (5.5%).At 4 months, 39% of patients had persistent f...

Source: European Respiratory Journal - November 25, 2021 Category: Respiratory Medicine Authors: Noel-Savina, E., Viatge, T., Faviez, G., Lepage, B., Mhanna, L., Pontier, S., Dupuis, M., Collot, S., Thomas, P., Idoate Lacasia, J., Crognier, L., Bouharaoua, S., Silva Sifontes, S., Mazieres, J., Prevot, G., Didier, A. Tags: Respiratory infections and bronchiectasis Source Type: research