Key Factors Associated With Pulmonary Sequelae in the Follow-Up of Critically Ill COVID-19 Patients

被引：4

作者：

Gonzalez, Jessica ^{[1
,2
]}

de Batlle, Jordi ^{[1
,2
]}

Benitez, Ivan D. ^{[1
,2
]}

Torres, Gerard ^{[1
,2
]}

Santisteve, Sally ^{[1
]}

Targa, Adriano D. S. ^{[1
,2
]}

Gort-Paniello, Clara ^{[1
,2
]}

Moncusi-Moix, Anna ^{[1
,2
]}

Aguila, Maria ^{[1
]}

Seck, Fatty ^{[1
,2
]}

Ceccato, Adrian ^{[2
,3
]}

Ferrer, Ricard ^{[4
]}

Motos, Anna ^{[2
,5
]}

Riera, Jordi ^{[4
]}

Fernandez, Laia ^{[2
,5
]}

Menendez, Rosario ^{[2
,6
]}

Lorente, Jose Angel ^{[2
,7
]}

Penuelas, Oscar ^{[2
,7
]}

Garcia-Gasulla, Dario ^{[8
]}

Penasco, Yhivian ^{[9
]}

Ricart, Pilar ^{[10
]}

Palomares, Elena Abril ^{[11
]}

Aguilera, Luciano ^{[12
]}

Rodriguez, Alejandro ^{[13
]}

Varela, Maria Victoria Boado ^{[14
]}

Betere, Belen ^{[15
]}

Pozo-Laderas, Juan Carlos ^{[16
]}

Sole-Violan, Jordi ^{[17
]}

Salvador-Adell, Inmaculada ^{[18
]}

Novo, Mariana Andrea ^{[19
]}

Barberan, Jose

Villar, Rosario Amaya ^{[21
]}

Garnacho-Montero, Jose ^{[22
]}

Gomez, Jose M. ^{[20
,23
]}

Ortiz, Aaron Blandino ^{[24
]}

Lomas, Luis Tamayo ^{[25
]}

Ubeda, Alejandro ^{[26
]}

Catalan-Gonzalez, Mercedes ^{[27
]}

Sanchez-Miralles, Angel ^{[28
]}

Varela, Ignacio Martinez ^{[29
]}

Garcia, Ruth Noemi Jorge ^{[30
]}

Franco, Nieves ^{[31
]}

Gumucio-Sanguino, Victor D. ^{[32
]}

Bustamante-Munguira, Elena ^{[33
]}

Valdivia, Luis Jorge ^{[34
]}

Caballero, Jesus ^{[35
]}

Gallego, Elena ^{[36
]}

Rodriguez, Covadonga ^{[37
]}

Castellanos-Ortega, Alvaro ^{[38
]}

Trenado, Josep ^{[39
]}

机构：

[1] Univ Hosp Arnau de Vilanova & Santa Maria, IRBLleida, Translat Res Resp Med, Lleida, Spain

[2] Inst Hlth Carlos III, CIBER Resp Dis CIBERES, Madrid, Spain

[3] ParcTauli Hosp Univ, I3PT, Crit Care Ctr, Sabadell, Spain

[4] Vall dHebron Hosp Univ, Vall dHebron Inst Recerca VHIR, Intens Care Dept, SODIR Res Grp, Barcelona, Spain

[5] Univ Barcelona, Hosp Clin Barcelona, August Pi & Sunyer Biomed Res Inst IDIBAPS, Dept Pneumol, Barcelona, Spain

[6] Univ & Polytech Hosp La Fe, Pulmonol Serv, Valencia, Spain

[7] Hosp Univ Getafe, Madrid, Spain

[8] BSC, Barcelona, Spain

[9] Hosp Univ Marques Valdecilla, Serv Med Intens, Santander, Spain

[10] Hosp Univ Germans Trias, Serv Med Intens, Badalona, Spain

[11] Hosp Univ Torrejon, Madrid, Spain

[12] Hosp Univ Basurto, Serv Anestesiol & Reanimac, Bilbao, Spain

[13] Hosp Joan 23, Crit Care Dept, Tarragona, Spain

[14] Hosp Cruces, Serv Med Intens, Baracaldo, Vizcaya, Spain

[15] Hosp Univ Principe Asturias, Serv Anal Clin, Alcala De Henares, Spain

[16] Hosp Univ Reina Sofia, UGC Med Intens, Inst Maimonides IMIBIC, Cordoba, Spain

[17] Univ Fernando Pessoa, Hosp Dr Negrin Gran Canaria, Crit Care Dept, Gran Canaria, Canarias, Spain

[18] Hosp Verge Cinta, Tarragona, Spain

[19] Hosp Univ Son Espases, Serv Med Intens, Palma De Mallorca, Illes Balears, Spain

[20] Univ San Pablo CEU, Hosp Univ HM Monteprincipe, Madrid, Spain

[21] Hosp Univ Virgen del Rocio, Intens Care Clin Unit, Seville, Spain

[22] Hosp Univ Virgen Macarena, Intens Care Clin Unit, Seville, Spain

[23] Hosp Gen Univ Gregorio Maranon, Madrid, Spain

[24] Hosp Univ Ramon & Cajal, Serv Med Intens, Madrid, Spain

[25] Hosp Univ Rio Hortega Valladolid, Crit Care Dept, Valladolid, Spain

[26] Hosp Punta Europa, Serv Med Intens, Algeciras, Spain

[27] Hosp Univ 12 Octubre, Dept Intens Care Med, Madrid, Spain

[28] Hosp St Joan Alacant, Alacant, Spain

[29] Hosp Univ Lucus Augusti, Crit Care Dept, Lugo, Spain

[30] Hosp Nuestra Senora Gracia, Intens Care Dept, Zaragoza, Spain

[31] Hosp Univ Mostoles, Madrid, Spain

[32] Hosp Univ Bellvitge, Dept Intens Care, Bellvitge Biomed Res Inst IDIBELL, Barcelona, Spain

[33] Hosp Clin Univ Valladolid, Dept Intens Care Med, Valladolid, Spain

[34] Hosp Univ Leon, Leon, Spain

[35] Hosp Arnau Vilanova, IRBLleida, Crit Care Dept, Lleida, Spain

[36] Hosp Univ San Pedro Alcantara, Unidad Cuidados Intens, Caceres, Spain

[37] Hosp Univ Infanta Leonor, Madrid, Spain

[38] Hosp Univ & Politecn La Fe, Serv Med Intens, Valencia, Spain

[39] Hosp Univ Mutua Terrassa, Serv Med Intens, Barcelona, Spain

[40] Hosp del Mar IMIM, Crit Care Dept, Barcelona, Spain

[41] Univ Oviedo, Inst Univ Oncol Principado Asturias, Inst Invest Sanitaria Principado Asturias, Dept Biol Func,Hosp Cent Asturias, Oviedo, Spain

[42] Hosp Mataro Barcelona, Barcelona, Spain

[43] Hosp Univ Virgen de Valme, Unidad Med Intens, Seville, Spain

[44] Complexo Hosp Univ Ourense, Orense, Spain

[45] Hosp Univ La Paz, Serv Med Intens, IdiPAZ, Madrid, Spain

[46] Hosp Alvaro Cunqueiro, Intens Care Unit, Vigo, Spain

[47] Hosp Univ Salamanca, Salamanca, Spain

[48] Hosp Clin & Univ Valencia, Intens Care Unit, Valencia, Spain

[49] Hosp Son Llatzer, Intens Care Unit, Palma De Mallorca, Illes Balears, Spain

[50] Hosp Santa Maria, IRBLleida, Lleida, Spain

来源：

ARCHIVOS DE BRONCONEUMOLOGIA | 2023年 / 59卷 / 04期

关键词：

COVID-19; CT abnormalities; ICU; Lung function; Sequelae; CLINICAL CHARACTERISTICS; CONSEQUENCES; DISEASE;

D O I：

10.1016/j.arbres.2022.12.017

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

Introduction: Critical COVID-19 survivors have a high risk of respiratory sequelae. Therefore, we aimed to identify key factors associated with altered lung function and CT scan abnormalities at a follow-up visit in a cohort of critical COVID-19 survivors.Methods: Multicenter ambispective observational study in 52 Spanish intensive care units. Up to 1327 PCR-confirmed critical COVID-19 patients had sociodemographic, anthropometric, comorbidity and lifestyle characteristics collected at hospital admission; clinical and biological parameters throughout hospital stay; and, lung function and CT scan at a follow-up visit.Results: The median [p25-p75] time from discharge to follow-up was 3.57 [2.77-4.92] months. Median age was 60 [53-67] years, 27.8% women. The mean (SD) percentage of predicted diffusing lung capacity for carbon monoxide (DLCO) at follow-up was 72.02 (18.33)% predicted, with 66% of patients having DLCO < 80% and 24% having DLCO < 60%. CT scan showed persistent pulmonary infiltrates, fibrotic lesions, and emphy-sema in 33%, 25% and 6% of patients, respectively. Key variables associated with DLCO < 60% were chronic lung disease (CLD) (OR: 1.86 (1.18-2.92)), duration of invasive mechanical ventilation (IMV) (OR: 1.56 (1.37-1.77)), age (OR [per-1-SD] (95%CI): 1.39 (1.18-1.63)), urea (OR: 1.16 (0.97-1.39)) and estimated glomerular filtration rate at ICU admission (OR: 0.88 (0.73-1.06)). Bacterial pneumonia (1.62 (1.11-2.35)) and duration of ventilation (NIMV (1.23 (1.06-1.42), IMV (1.21 (1.01-1.45)) and prone positioning (1.17 (0.98-1.39)) were associated with fibrotic lesions. Conclusion: Age and CLD, reflecting patients' baseline vulnerability, and markers of COVID-19 sever-ity, such as duration of IMV and renal failure, were key factors associated with impaired DLCO and CT abnormalities.Published by Elsevier Espan similar to a, S.L.U. on behalf of SEPAR.

引用

页码：205 / 215

页数：11

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