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Long-Term Sequelae of severe COVID-19: Outpatient assessment of radiological and pulmonary function tests
OBJECTIVE: Identify lung sequelae of COVID-19 through radiological and pulmonary function assessment. DESIGN: Prospective, longitudinal, cohort study from March 2020 to March 2021. SETTING: Intensive Care Units (ICU) in a tertiary hospital in Portugal. PATIENTS: 254 patients with COVID-19 admitted t...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Authors. Published by Elsevier España, S.L.U.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10020040/ http://dx.doi.org/10.1016/j.mcpsp.2023.100373 |
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author | Ribeiro-Dias, Lúcia Fernandes, Joana Braga, António Vieira, Tatiana Madureira, António Hespanhol, Vencelau Coimbra, Isabel Paiva, José Artur Santos, Lurdes Silva-Pinto, André |
author_facet | Ribeiro-Dias, Lúcia Fernandes, Joana Braga, António Vieira, Tatiana Madureira, António Hespanhol, Vencelau Coimbra, Isabel Paiva, José Artur Santos, Lurdes Silva-Pinto, André |
author_sort | Ribeiro-Dias, Lúcia |
collection | PubMed |
description | OBJECTIVE: Identify lung sequelae of COVID-19 through radiological and pulmonary function assessment. DESIGN: Prospective, longitudinal, cohort study from March 2020 to March 2021. SETTING: Intensive Care Units (ICU) in a tertiary hospital in Portugal. PATIENTS: 254 patients with COVID-19 admitted to ICU due to respiratory illness. INTERVENTIONS: A chest computed tomography (CT) scan and pulmonary function tests (PFT) were performed at 3 to 6 months. MAIN VARIABLES OF INTEREST: CT-scan; PFT; decreased diffusion capacity of carbon monoxide (DLCO). RESULTS: All CT scans revealed improvement in the follow-up, with 72% of patients still showing abnormalities, 58% with ground glass opacities and 62% with evidence of fibrosis. PFT had abnormalities in 94 patients (46%): thirteen patients (7%) had an obstructive pattern, 35 (18%) had a restrictive pattern, and 58 (30%) had decreased DLCO. There was a statistically significant association between abnormalities in the follow-up CT scan and older age, more extended hospital and ICU stay, higher SAPS II and APACHE scores and invasive ventilation. Mechanical ventilation, especially with no lung protective parameters, was associated with abnormalities in PFT. Multivariate regression showed more abnormalities in lung function with more extended ICU hospitalization, chronic obstructive pulmonary disease (COPD), chronic kidney disease, invasive mechanical ventilation, and ventilation with higher plateau pressure, and more abnormalities in CT-scan with older age, more extended ICU stay, organ solid transplants and ventilation with higher positive end-expiratory pressure (PEEP). CONCLUSIONS: Most patients with severe COVID-19 still exhibit abnormalities in CT scans or lung function tests three to six months after discharge. |
format | Online Article Text |
id | pubmed-10020040 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | The Authors. Published by Elsevier España, S.L.U. |
record_format | MEDLINE/PubMed |
spelling | pubmed-100200402023-03-17 Long-Term Sequelae of severe COVID-19: Outpatient assessment of radiological and pulmonary function tests Ribeiro-Dias, Lúcia Fernandes, Joana Braga, António Vieira, Tatiana Madureira, António Hespanhol, Vencelau Coimbra, Isabel Paiva, José Artur Santos, Lurdes Silva-Pinto, André Medicina Clínica Práctica Original Article OBJECTIVE: Identify lung sequelae of COVID-19 through radiological and pulmonary function assessment. DESIGN: Prospective, longitudinal, cohort study from March 2020 to March 2021. SETTING: Intensive Care Units (ICU) in a tertiary hospital in Portugal. PATIENTS: 254 patients with COVID-19 admitted to ICU due to respiratory illness. INTERVENTIONS: A chest computed tomography (CT) scan and pulmonary function tests (PFT) were performed at 3 to 6 months. MAIN VARIABLES OF INTEREST: CT-scan; PFT; decreased diffusion capacity of carbon monoxide (DLCO). RESULTS: All CT scans revealed improvement in the follow-up, with 72% of patients still showing abnormalities, 58% with ground glass opacities and 62% with evidence of fibrosis. PFT had abnormalities in 94 patients (46%): thirteen patients (7%) had an obstructive pattern, 35 (18%) had a restrictive pattern, and 58 (30%) had decreased DLCO. There was a statistically significant association between abnormalities in the follow-up CT scan and older age, more extended hospital and ICU stay, higher SAPS II and APACHE scores and invasive ventilation. Mechanical ventilation, especially with no lung protective parameters, was associated with abnormalities in PFT. Multivariate regression showed more abnormalities in lung function with more extended ICU hospitalization, chronic obstructive pulmonary disease (COPD), chronic kidney disease, invasive mechanical ventilation, and ventilation with higher plateau pressure, and more abnormalities in CT-scan with older age, more extended ICU stay, organ solid transplants and ventilation with higher positive end-expiratory pressure (PEEP). CONCLUSIONS: Most patients with severe COVID-19 still exhibit abnormalities in CT scans or lung function tests three to six months after discharge. The Authors. Published by Elsevier España, S.L.U. 2023 2023-03-17 /pmc/articles/PMC10020040/ http://dx.doi.org/10.1016/j.mcpsp.2023.100373 Text en © 2023 The Authors. Published by Elsevier España, S.L.U. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Original Article Ribeiro-Dias, Lúcia Fernandes, Joana Braga, António Vieira, Tatiana Madureira, António Hespanhol, Vencelau Coimbra, Isabel Paiva, José Artur Santos, Lurdes Silva-Pinto, André Long-Term Sequelae of severe COVID-19: Outpatient assessment of radiological and pulmonary function tests |
title | Long-Term Sequelae of severe COVID-19: Outpatient assessment of radiological and pulmonary function tests |
title_full | Long-Term Sequelae of severe COVID-19: Outpatient assessment of radiological and pulmonary function tests |
title_fullStr | Long-Term Sequelae of severe COVID-19: Outpatient assessment of radiological and pulmonary function tests |
title_full_unstemmed | Long-Term Sequelae of severe COVID-19: Outpatient assessment of radiological and pulmonary function tests |
title_short | Long-Term Sequelae of severe COVID-19: Outpatient assessment of radiological and pulmonary function tests |
title_sort | long-term sequelae of severe covid-19: outpatient assessment of radiological and pulmonary function tests |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10020040/ http://dx.doi.org/10.1016/j.mcpsp.2023.100373 |
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