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Health-related quality of life profiles, trajectories, persistent symptoms and pulmonary function one year after ICU discharge in invasively ventilated COVID-19 patients, a prospective follow-up study

2021; Elsevier BV; Volume: 189; Linguagem: Inglês

10.1016/j.rmed.2021.106665

1532-3064

Lorenzo Gamberini, Carlo Alberto Mazzoli, Irene Prediletto, Harri Sintonen, Gaetano Scaramuzzo, Davide Allegri, Davide Colombo, Tommaso Tonetti, Gianluca Zani, Chiara Capozzi, Giorgia Dalpiaz, Vanni Agnoletti, Iacopo Cappellini, Gabriele Melegari, Federica Damiani, Maurizio Fusari, Giovanni Gordini, Cristiana Laici, Maria Concetta Lanza, Mirco Leo, Andrea Marudi, Raffaella Papa, Antonella Potalivo, Jonathan Montomoli, Stefania Taddei, Massimiliano Mazzolini, Anna Filomena Ferravante, Roberta Nicali, V. Marco Ranieri, Emanuele Russo, Carlo Alberto Volta, Savino Spadaro, Marco Tartaglione, Valentina Chiarini, Virginia Buldini, Carlo Coniglio, Federico Moro, Silvia Orlando, Daniele Fecarotti, Nicola Cilloni, L Giuntoli, Angela Bellocchio, Emanuele Matteo, Giacinto Pizzilli, Antonio Daniele Pinna, Chiara Tartivita, Irene Cavalli, Andrea Castelli, Annalisa Marchio, Igor Bacchilega, Laura Bernabé, Francesca Facondini, Luca Morini, Luca Bissoni, Lorenzo Viola, Tommaso Meconi, Vittorio Pavoni, Angelica Venni, Aline Pagni, Patrizia Pompa Cleta, Marco Cavagnino, Alessia Guzzo, Anna Malfatto, Angelina Adduci, Silvia Pareschi, Elisabetta Bertellini, Jessica Maccieri, Elisa Marinangeli, Fabrizio Racca, Marco Verri, Giulia Falò, Elisabetta Marangoni, Irene Ottaviani, Francesco Bonì, Giulia Felloni, Federico Domenico Baccarini, Marina Terzitta, Stefano Maitan, Lorenzo Tutino, Angelo Senzi, Guglielmo Consales, Filippo Becherucci, Michele Imbriani, Paolo Emilio Orlandi, Silvia Candini, Rita Golfieri, Federica Ciccarese, Antonio Poerio, Francesco Muratore, Fabio Ferrari, Martina Mughetti, Emanuela Giampalma, Loredana Franchini, Ersenad Neziri, Marco Miceli, Maria Teresa Minguzzi, Lorenzo Mellini, Sara Piciucchi, Matteo Monari, Michele Valli, Federico Daniele, Martina Ferioli, Stefano Nava, Luigi Arcangelo Lazzari Agli, Ilaria Valentini, Eva Bernardi, Bruno Balbi, Marco Contoli, Marianna Padovani, Stefano Oldani, Claudia Ravaglia, P Goti,

Respiratory Support and Mechanisms

BackgroundHealth-related quality of life (HRQoL) impairment is often reported among COVID-19 ICU survivors, and little is known about their long-term outcomes.We evaluated the HRQoL trajectories between 3 months and 1 year after ICU discharge, the factors influencing these trajectories and the presence of clusters of HRQoL profiles in a population of COVID-19 patients who underwent invasive mechanical ventilation (IMV). Moreover, pathophysiological correlations of residual dyspnea were tested.MethodsWe followed up 178 survivors from 16 Italian ICUs up to one year after ICU discharge. HRQoL was investigated through the 15D instrument. Available pulmonary function tests (PFTs) and chest CT scans at 1 year were also collected. A linear mixed-effects model was adopted to identify factors associated with different HRQoL trajectories and a two-step cluster analysis was performed to identify HRQoL clusters.ResultsWe found that HRQoL increased during the study period, especially for the significant increase of the physical dimensions, while the mental dimensions and dyspnea remained substantially unchanged. Four main 15D profiles were identified: full recovery (47.2%), bad recovery (5.1%) and two partial recovery clusters with mostly physical (9.6%) or mental (38.2%) dimensions affected. Gender, duration of IMV and number of comorbidities significantly influenced HRQoL trajectories. Persistent dyspnea was reported in 58.4% of patients, and weakly, but significantly, correlated with both DLCO and length of IMV.ConclusionsHRQoL impairment is frequent 1 year after ICU discharge, and the lowest recovery is found in the mental dimensions. Persistent dyspnea is often reported and weakly correlated with PFTs alterations.Trial registrationNCT04411459.