Post-COVID-19 condition in patients receiving invasive positive pressure ventilation or high flow nasal cannula therapy.

BACKGROUND

Invasive positive pressure ventilation (IPPV) and high-flow nasal cannula (HFNC) are often employed for severe COVID-19 patients. Such advanced respiratory support might influence the post-COVID-19 condition (PCC). Here, we investigated the potential association between advanced respiratory support and PCC.

METHODS

This study is ancillary to the separately reported multicenter observational study that included moderate to severe COVID-19 patients who required hospitalization between September 2020 and September 2021 in Japan. PCC symptoms, chest CT images, and lung function tests were evaluated 3 months after discharge. Frequency of PCC was compared between patients with and without advanced respiratory support using propensity score matching including severity on admission.

RESULTS

Among 714 participants, 100 received advanced respiratory support (IPPV: 56, HFNC: 44). Patients who received advanced respiratory support significantly more frequently had PCC symptoms, CT abnormalities, and lung dysfunction. However, comparison of propensity score-matched controls indicated no significant differences in the frequency of symptoms, although CT and lung function abnormalities remained significantly higher. Furthermore, these differences were only observed in elderly patients. There were no differences in the frequency of PCC between patients with IPPV versus HFNC therapy.

CONCLUSIONS

Patients treated with IPPV or HFNC showed more PCC symptoms that were largely related to the initial disease severity. CT and pulmonary function abnormalities were also more frequent in such patients, especially the elderly, although this showed no correlation with disease severity. These findings underscore the correlation between age and PCC in COVID-19 patients who received advanced respiratory support. This study was registered in the UMIN Clinical Trials Registry (UMIN-CTR) under the identifier UMIN000041168.