Department of Anaesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.
IRCCS San Raffaele Scientific Institute, Hematology and Bone Marrow Transplant Unit, Milan, Italy.
Acta Anaesthesiol Scand. 2021 Aug;65(7):912-920. doi: 10.1111/aas.13812. Epub 2021 Mar 15.
COVID-19 disease can lead to severe functional impairments after discharge. We assessed the quality of life of invasively ventilated COVID-19 ARDS survivors.
We carried out a prospective follow-up study of the patients admitted to the Intensive Care Units (ICUs) of a teaching hospital. Patients affected by COVID-19 ARDS who required invasive ventilation and were successfully discharged home were assessed through the telephone administration of validated tests. We explored survival, functional outcomes, return to work, quality of life, cognitive and psychological sequelae. The main variables of interest were the following: demographics, severity scores, laboratory values, comorbidities, schooling, working status, treatments received during ICU stay, complications, and psychological, cognitive, functional outcomes.
Out of 116 consecutive invasively ventilated patients, overall survival was 65/116 (56%) with no death occurring after hospital discharge. Forty-two patients were already discharged home with a median follow-up time of 61 (51-71) days after ICU discharge and 39 of them accepted to be interviewed. Only one patient (1/39) experienced cognitive decline. The vast majority of patients reported no difficulty in walking (32/35:82%), self-care (33/39:85%), and usual activities (30/39:78%). All patients were either malnourished (15/39:38%) or at risk for malnutrition (24/39:62%). Exertional dyspnea was present in 20/39 (51%) patients. 19/39 (49%) reported alterations in senses of smell and/or taste either before or after hospitalization.
Invasively ventilated COVID-19 ARDS survivors have an overall good recovery at a 2-months follow-up which is better than what was previously reported in non-COVID-19 ARDS patients.
COVID-19 疾病在出院后可能导致严重的功能障碍。我们评估了接受有创通气的 COVID-19 急性呼吸窘迫综合征（ARDS）幸存者的生活质量。
我们对一家教学医院的重症监护病房（ICU）收治的患者进行了前瞻性随访研究。通过电话对接受有创通气且成功出院回家的 COVID-19 ARDS 患者进行了评估，并使用经过验证的测试。我们探讨了生存、功能结局、重返工作岗位、生活质量、认知和心理后遗症。主要关注的变量如下：人口统计学、严重程度评分、实验室值、合并症、教育程度、工作状态、在 ICU 期间接受的治疗、并发症以及心理、认知和功能结局。
在 116 例连续接受有创通气的患者中，整体存活率为 65/116（56%），出院后无死亡发生。42 例患者已出院回家，中位随访时间为 ICU 出院后 61（51-71）天，其中 39 例接受了采访。仅有 1 例患者（1/39）出现认知能力下降。绝大多数患者报告在行走（32/35：82%）、自理（33/39：85%）和日常活动（30/39：78%）方面没有困难。所有患者均存在营养不良（15/39：38%）或有营养不良风险（24/39：62%）。20/39（51%）的患者出现运动性呼吸困难。19/39（49%）的患者报告嗅觉和/或味觉改变，无论是在住院前还是住院后。
在 2 个月的随访中，接受有创通气的 COVID-19 ARDS 幸存者总体恢复良好，优于非 COVID-19 ARDS 患者的先前报告。
