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Key Factors Associated With Pulmonary Sequelae in the Follow-Up of Critically Ill COVID-19 Patients

2023; Elsevier BV; Volume: 59; Issue: 4 Linguagem: Inglês

10.1016/j.arbres.2022.12.017

1885-6195

Jessica González, Jordi de Batlle, Iván D. Benítez, Gerard Torres, Sally Santisteve, Adriano Targa, Clara Gort‐Paniello, Anna Moncusí‐Moix, Maria Aguilà, Fatty Seck, Adrián Ceccato, Ricard Ferrer, Ana Motos, Jordi Riera, Laia Fernández‐Barat, Rosario Menéndez, José Ángel Lorente, Óscar Peñuelas, Dario García-Gasulla, Yhivian Peñasco, Pilar Ricart, Elena Abril, Luciano Aguilera, Alejandro Rodríguez, Maria Victoria Boado Varela, Belén Beteré, Juan Carlos Pozo-Laderas, Jordi Solé‐Violán, Inmaculada Salvador-Adell, Mariana Andrea Novo, José Barberán, Rosario Amaya Villar, José Garnacho‐Montero, José María Gómez, Aaron Blandino Ortíz, Luis Tamayo Lomas, Alejandro Úbeda, Mercedes Catalán-González, Ángel Sánchez-Miralles, Ignacio Martínez Varela, Ruth Noemí Jorge García, Nieves Franco, Víctor D. Gumucio-Sanguino, Elena Bustamante‐Munguira, Luis Jorge Valdivia, Jesús Caballero, Elena Gallego, C. Rodríguez, Álvaro Castellanos-Ortega, Josep Trenado, Judith Marín‐Corral, Guillermo M. Albaiceta, María del Carmen de la Torre, Ana Loza-Vázquez, Pablo Vidal, José M. Añón, Cristina Carbajales Pérez, Víctor Sagredo-Meneses, Nieves Carbonell, Lorenzo Socías, Carme Barberà, Ángel Estella, Emili Dı́az, David de Gonzalo‐Calvo, Antoni Torres, Ferrán Barbé, María Aguilar Cabello, Victoria Alcaraz-Serrano, César Aldecoa, Cynthia Alegre, Ángela Algaba Calderón, Sergio Álvarez, Antonio Álvarez Ruiz, Rut Andrea, Maria de Alba Aparicio, Marta Arrieta, Ignacio Ayestarán, Joan R. Badia, Mariona Badía, Orville Báez Pravia, Ana Balan Mariño, Begoña Balsera, Laura Barbena, Enric Barbeta, Tommaso Bardi, Patricia Barral Segade, Marta Barroso, José Ángel Berezo García, Jesús F Bermejo, Judit Bigas, Rafael Blancas, María Luisa Blasco, María Bodi Saera, Neus Bofill, María Teresa Bouza Vieiro, Leticia Bueno, Juan Bustamante‐Munguira, Cecilia del Busto Martínez, David Campi Hermoso, Sandra Campos Fernández, Iosune Cano, Joan Canseco, Pablo Cardinal Fernández, Laura Carrión García, Sulamita Carvalho, Manuel Castellá, Andrea Castellví, Pedro Castro, María José Centelles-Serrano, Ramón Cicuéndez Avila, Catia Cillóniz, Luisa Clar, Cristina Climent, Jordi Codina, Pamela Conde, Sofía Contreras, Raul de Frutos Parra, Raúl de Pablo, Diego de Mendoza, Yolanda Díaz, María Digna Rivas Vilas, Cristina Moreno, Irene Dot, Pedro Enríquez Giraudo, Inés Esmorís Arijón, Teresa Farre Monjo, Javier Fernández, Carlos Ferrando, Albert Figueras, Lorena Forcelledo Espina, Enric Franquesa, Àngels Furro, Albert Gabarrús, Cristobal Galbán‐Malagón, Felipe Pérez‐García, Beatriz García, Emilio García-Prieto, Carlos García Redruello, Amaia García Sagastume, Maria Luisa Gascón Castillo, Gemma Gomà, Vanesa Gómez Casal, Sílvia Gómez, Carmen Gómez González, Federico Gordo, M.P. Gracia, María José Gutierrez Fernández, Alba Herraiz, Rubén Herrán‐Monge, Mercedes Ibarz, Sílvia Iglesias, Maria Teresa Janer, Gabriel Jiménez, Mar Juan Díaz, Karsa Kiarostami, Juan I. Lazo Álvarez, Miguel Leonardo García León, Alexandre López-Gavín, Desiree Macías Guerrero, Nuria Mamolar Herrera, Rafael Máñez, Cecilia L. Mantellini, Gregorio Marco Naya, Iris Marco Barcos, Pilar Marcos, Enrique Marmol Peis, Marta Cuadrado, M.C. Martín Delgado, Paula Martín Vicente, María Martínez-Martínez, Carmen Eulalia Martínez Fernández, Maria Dolores Martínez Juan, Basilisa Martínez Palacios, J.F. Masa Jiménez, Joan Ramón Masclans, Emilio Maseda, Eva María Menor Fernández, Priscila Metora Banderas, Olga Mínguez, Mar Miralbés, Josman Monclou, Juan Carlos Montejo, Neus Montserrat, María Mora Aznar, Dulce Morales, Sara Guadalupe Moreno Cano, David Mosquera Rodríguez, Rosana Muñoz-Bermúdez, José M. Nicolás, Ramón Nogué Bou, Rafaela Nogueras Salinas, Marta Ocón, Ana Ortega, Sergio Ossa, Pablo Pagliarani, F. Gómez, J. Pedregosa-Díaz, Leire Pérez Bastida, Purificación Pérez, Felipe Pérez‐García, Gloria Pérez Planelles, Eva Pérez Rubio, David Pestaña Laguna, Javier Prados, Andrés Pujol, Núria Ramon Coll, Gloria Renedo Sánchez‐Girón, Ferran Roche‐Campo, Laura Rodríguez, Felipe Rodrı́guez de Castro, Silvia Rodríguez, Covadonga Rodríguez Ruíz, Jorge Rubio, Alberto Rubio-López, Ángela Leonor Ruiz-García, Miriam Ruiz Miralles, Pablo Ryan, Eva Saborido Paz, Ana Salazar Degracia, Miguel Sánchez, Ana Sánchez, Susana Sancho Chinesta, Bitor Santacoloma, Miguel Sánchez, María Teresa Sariñena, Marta Segura Pensado, Lidia Serra, Mireia Serra-Fortuny, Ainhoa Serrano, Luis Serviá, Laura Soliva, Carla Speziale, Adrián Tormos, Mateu Torres, Celia Tranque-Liberal, Sandra Trefler, Javier Trujillano, Rafaela Vaca, Estela Val, Luis Valdivia Ruiz, Montserrat Vallverdú, Maria Van der Hofstadt Martin-Montalvo, Sabela Vara Adrio, Nil Vázquez, Javier Vengoechea, C. Vilà, Judit Vilanova, Tatiana Villada Warrington, Hua Yang, Minlan Yang, Ana Zapatero,

COVID-19 Clinical Research Studies

Critical COVID-19 survivors have a high risk of respiratory sequelae. Therefore, we aimed to identify key factors associated with altered lung function and CT scan abnormalities at a follow-up visit in a cohort of critical COVID-19 survivors.Multicenter ambispective observational study in 52 Spanish intensive care units. Up to 1327 PCR-confirmed critical COVID-19 patients had sociodemographic, anthropometric, comorbidity and lifestyle characteristics collected at hospital admission; clinical and biological parameters throughout hospital stay; and, lung function and CT scan at a follow-up visit.The median [p25-p75] time from discharge to follow-up was 3.57 [2.77-4.92] months. Median age was 60 [53-67] years, 27.8% women. The mean (SD) percentage of predicted diffusing lung capacity for carbon monoxide (DLCO) at follow-up was 72.02 (18.33)% predicted, with 66% of patients having DLCO<80% and 24% having DLCO<60%. CT scan showed persistent pulmonary infiltrates, fibrotic lesions, and emphysema in 33%, 25% and 6% of patients, respectively. Key variables associated with DLCO<60% were chronic lung disease (CLD) (OR: 1.86 (1.18-2.92)), duration of invasive mechanical ventilation (IMV) (OR: 1.56 (1.37-1.77)), age (OR [per-1-SD] (95%CI): 1.39 (1.18-1.63)), urea (OR: 1.16 (0.97-1.39)) and estimated glomerular filtration rate at ICU admission (OR: 0.88 (0.73-1.06)). Bacterial pneumonia (1.62 (1.11-2.35)) and duration of ventilation (NIMV (1.23 (1.06-1.42), IMV (1.21 (1.01-1.45)) and prone positioning (1.17 (0.98-1.39)) were associated with fibrotic lesions.Age and CLD, reflecting patients' baseline vulnerability, and markers of COVID-19 severity, such as duration of IMV and renal failure, were key factors associated with impaired DLCO and CT abnormalities.