Key Factors Associated With Pulmonary Sequelae in the Follow-Up of Critically Ill COVID-19 Patients.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
González Jessica, de Batlle Jordi, Benítez Iván D, Torres Gerard, Santisteve Sally, Targa Adriano D S, Gort-Paniello Clara, Moncusí-Moix Anna, Aguilà Maria, Seck Fatty, Ceccato Adrián, Ferrer Ricard, Motos Anna, Riera Jordi, Fernández Laia, Menéndez Rosario, Lorente José Ángel, Peñuelas Oscar, Garcia-Gasulla Dario, Peñasco Yhivian, Ricart Pilar, Abril Palomares Elena, Aguilera Luciano, Rodríguez Alejandro, Boado Varela Maria Victoria, Beteré Belén, Pozo-Laderas Juan Carlos, Solé-Violan Jordi, Salvador-Adell Inmaculada, Novo Mariana Andrea, Barberán José, Amaya Villar Rosario, Garnacho-Montero José, Gómez José M, Blandino Ortiz Aaron, Tamayo Lomas Luis, Úbeda Alejandro, Catalán-González Mercedes, Sánchez-Miralles Angel, Martínez Varela Ignacio, Jorge García Ruth Noemí, Franco Nieves, Gumucio-Sanguino Víctor D, Bustamante-Munguira Elena, Valdivia Luis Jorge, Caballero Jesús, Gallego Elena, Rodríguez Covadonga, Castellanos-Ortega Álvaro, Trenado Josep, Marin-Corral Judith, Albaiceta Guillermo M, de la Torre Maria Del Carmen, Loza-Vázquez Ana, Vidal Pablo, Añón Jose M, Carbajales Pérez Cristina, Sagredo Victor, Carbonell Nieves, Socias Lorenzo, Barberà Carme, Estella Angel, Diaz Emili, de Gonzalo-Calvo David, Torres Antoni, Barbé Ferran, CIBERESUCICOVID Project
Аннотация
METHODS: 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.
RESULTS: 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.
CONCLUSION: 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.