Author:
González Jessica,Zuil María,Benítez Iván D.,de Gonzalo-Calvo David,Aguilar María,Santisteve Sally,Vaca Rafaela,Minguez Olga,Seck Faty,Torres Gerard,de Batlle Jordi,Gómez Silvia,Barril Silvia,Moncusí-Moix Anna,Monge Aida,Gort-Paniello Clara,Ferrer Ricard,Ceccato Adrián,Fernández Laia,Motos Ana,Riera Jordi,Menéndez Rosario,Garcia-Gasulla Darío,Peñuelas Oscar,Labarca Gonzalo,Caballero Jesús,Barberà Carme,Torres Antoni,Barbé Ferran
Abstract
The long-term clinical management and evolution of a cohort of critical COVID-19 survivors have not been described in detail. We report a prospective observational study of COVID-19 patients admitted to the ICU between March and August 2020. The follow-up in a post-COVID consultation comprised symptoms, pulmonary function tests, the 6-minute walking test (6MWT), and chest computed tomography (CT). Additionally, questionnaires to evaluate the prevalence of post-COVID-19 syndrome were administered at 1 year. A total of 181 patients were admitted to the ICU during the study period. They were middle-aged (median [IQR] of 61 [52;67]) and male (66.9%), with a median ICU stay of 9 (5–24.2) days. 20% died in the hospital, and 39 were not able to be included. A cohort of 105 patients initiated the follow-up. At 1 year, 32.2% persisted with respiratory alterations and needed to continue the follow-up. Ten percent still had moderate/severe lung diffusion (DLCO) involvement (<60%), and 53.7% had a fibrotic pattern on CT. Moreover, patients had a mean (SD) number of symptoms of 5.7 ± 4.6, and 61.3% met the criteria for post-COVID syndrome at 1 year. During the follow-up, 46 patients were discharged, and 16 were transferred to other consultations. Other conditions, such as emphysema (21.6%), COPD (8.2%), severe neurocognitive disorders (4.1%), and lung cancer (1%) were identified. A high use of health care resources is observed in the first year. In conclusion, one-third of critically ill COVID-19 patients need to continue follow-up beyond 1 year, due to abnormalities on DLCO, chest CT, or persistent symptoms.
Funder
Instituto de Salud Carlos III
European Regional Development Fund