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Cluster analysis unveils a severe persistent respiratory impairment phenotype 3-months after severe COVID-19
BACKGROUND: The mid-term respiratory sequelae in survivors of severe COVID-19 appear highly heterogeneous. In addition, factors associated with respiratory sequelae are not known. In this monocentric prospective study, we performed a multidisciplinary assessment for respiratory and muscular impairme...
Autores principales: | , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9344257/ https://www.ncbi.nlm.nih.gov/pubmed/35918719 http://dx.doi.org/10.1186/s12931-022-02111-9 |
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author | Perotin, Jeanne-Marie Gierski, Fabien Bolko, Lois Dury, Sandra Barrière, Sarah Launois, Claire Dewolf, Maxime Chouabe, Stéphane Bongrain, Eric Picard, Davy Tran, Eric N’Guyen, Yoann Mourvillier, Bruno Servettaz, Amélie Rapin, Amandine Marcus, Claude Lebargy, François Kaladjian, Arthur Salmon, Jean-Hugues Deslee, Gaetan |
author_facet | Perotin, Jeanne-Marie Gierski, Fabien Bolko, Lois Dury, Sandra Barrière, Sarah Launois, Claire Dewolf, Maxime Chouabe, Stéphane Bongrain, Eric Picard, Davy Tran, Eric N’Guyen, Yoann Mourvillier, Bruno Servettaz, Amélie Rapin, Amandine Marcus, Claude Lebargy, François Kaladjian, Arthur Salmon, Jean-Hugues Deslee, Gaetan |
author_sort | Perotin, Jeanne-Marie |
collection | PubMed |
description | BACKGROUND: The mid-term respiratory sequelae in survivors of severe COVID-19 appear highly heterogeneous. In addition, factors associated with respiratory sequelae are not known. In this monocentric prospective study, we performed a multidisciplinary assessment for respiratory and muscular impairment and psychological distress 3 months after severe COVID-19. We analysed factors associated with severe persistent respiratory impairment, amongst demographic, COVID-19 severity, and 3-month assessment. METHODS: Patients with severe SARS-CoV-2 pneumonia requiring ≥ 4L/min were included for a systematic 3-month visit, including respiratory assessment (symptoms, lung function, CT scan), muscular evaluation (body composition, physical function and activity, disability), psychopathological evaluation (anxiety, depression, post-traumatic stress disorder-PTSD) and quality of life. A cluster analysis was performed to identify subgroups of patients based on objective functional measurements: D(LCO), total lung capacity and 6-min walking distance (6MWD). RESULTS: Sixty-two patients were analysed, 39% had dyspnea on exercise (mMRC ≥ 2), 72% had D(LCO) < 80%, 90% had CT-scan abnormalities; 40% had sarcopenia/pre-sarcopenia and 31% had symptoms of PTSD. Cluster analysis identified a group of patients (n = 18, 30.5%) with a severe persistent (SP) respiratory impairment (D(LCO) 48 ± 12%, 6MWD 299 ± 141 m). This SP cluster was characterized by older age, severe respiratory symptoms, but also sarcopenia/pre-sarcopenia, symptoms of PTSD and markedly impaired quality of life. It was not associated with initial COVID-19 severity or management. CONCLUSIONS AND CLINICAL IMPLICATION: We identified a phenotype of patients with severe persistent respiratory and muscular impairment and psychological distress 3 months after severe COVID-19. Our results highlight the need for multidisciplinary assessment and management after severe SARS-CoV-2 pneumonia. Trial registration The study was registered on ClinicalTrials.gov (May 6, 2020): NCT04376840 SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12931-022-02111-9. |
format | Online Article Text |
id | pubmed-9344257 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-93442572022-08-02 Cluster analysis unveils a severe persistent respiratory impairment phenotype 3-months after severe COVID-19 Perotin, Jeanne-Marie Gierski, Fabien Bolko, Lois Dury, Sandra Barrière, Sarah Launois, Claire Dewolf, Maxime Chouabe, Stéphane Bongrain, Eric Picard, Davy Tran, Eric N’Guyen, Yoann Mourvillier, Bruno Servettaz, Amélie Rapin, Amandine Marcus, Claude Lebargy, François Kaladjian, Arthur Salmon, Jean-Hugues Deslee, Gaetan Respir Res Research BACKGROUND: The mid-term respiratory sequelae in survivors of severe COVID-19 appear highly heterogeneous. In addition, factors associated with respiratory sequelae are not known. In this monocentric prospective study, we performed a multidisciplinary assessment for respiratory and muscular impairment and psychological distress 3 months after severe COVID-19. We analysed factors associated with severe persistent respiratory impairment, amongst demographic, COVID-19 severity, and 3-month assessment. METHODS: Patients with severe SARS-CoV-2 pneumonia requiring ≥ 4L/min were included for a systematic 3-month visit, including respiratory assessment (symptoms, lung function, CT scan), muscular evaluation (body composition, physical function and activity, disability), psychopathological evaluation (anxiety, depression, post-traumatic stress disorder-PTSD) and quality of life. A cluster analysis was performed to identify subgroups of patients based on objective functional measurements: D(LCO), total lung capacity and 6-min walking distance (6MWD). RESULTS: Sixty-two patients were analysed, 39% had dyspnea on exercise (mMRC ≥ 2), 72% had D(LCO) < 80%, 90% had CT-scan abnormalities; 40% had sarcopenia/pre-sarcopenia and 31% had symptoms of PTSD. Cluster analysis identified a group of patients (n = 18, 30.5%) with a severe persistent (SP) respiratory impairment (D(LCO) 48 ± 12%, 6MWD 299 ± 141 m). This SP cluster was characterized by older age, severe respiratory symptoms, but also sarcopenia/pre-sarcopenia, symptoms of PTSD and markedly impaired quality of life. It was not associated with initial COVID-19 severity or management. CONCLUSIONS AND CLINICAL IMPLICATION: We identified a phenotype of patients with severe persistent respiratory and muscular impairment and psychological distress 3 months after severe COVID-19. Our results highlight the need for multidisciplinary assessment and management after severe SARS-CoV-2 pneumonia. Trial registration The study was registered on ClinicalTrials.gov (May 6, 2020): NCT04376840 SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12931-022-02111-9. BioMed Central 2022-08-02 2022 /pmc/articles/PMC9344257/ /pubmed/35918719 http://dx.doi.org/10.1186/s12931-022-02111-9 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Perotin, Jeanne-Marie Gierski, Fabien Bolko, Lois Dury, Sandra Barrière, Sarah Launois, Claire Dewolf, Maxime Chouabe, Stéphane Bongrain, Eric Picard, Davy Tran, Eric N’Guyen, Yoann Mourvillier, Bruno Servettaz, Amélie Rapin, Amandine Marcus, Claude Lebargy, François Kaladjian, Arthur Salmon, Jean-Hugues Deslee, Gaetan Cluster analysis unveils a severe persistent respiratory impairment phenotype 3-months after severe COVID-19 |
title | Cluster analysis unveils a severe persistent respiratory impairment phenotype 3-months after severe COVID-19 |
title_full | Cluster analysis unveils a severe persistent respiratory impairment phenotype 3-months after severe COVID-19 |
title_fullStr | Cluster analysis unveils a severe persistent respiratory impairment phenotype 3-months after severe COVID-19 |
title_full_unstemmed | Cluster analysis unveils a severe persistent respiratory impairment phenotype 3-months after severe COVID-19 |
title_short | Cluster analysis unveils a severe persistent respiratory impairment phenotype 3-months after severe COVID-19 |
title_sort | cluster analysis unveils a severe persistent respiratory impairment phenotype 3-months after severe covid-19 |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9344257/ https://www.ncbi.nlm.nih.gov/pubmed/35918719 http://dx.doi.org/10.1186/s12931-022-02111-9 |
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