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One Year Overview and Follow-Up in a Post-COVID Consultation of Critically Ill Patients

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 sympt...

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Detalles Bibliográficos
Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9329578/
https://www.ncbi.nlm.nih.gov/pubmed/35911414
http://dx.doi.org/10.3389/fmed.2022.897990
Descripción
Sumario: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.