Martin-Loeches Ignacio, Motos Anna, Menéndez Rosario, Gabarrús Albert, González Jessica, Fernández-Barat Laia, Ceccato Adrián, Pérez-Arnal Raquel, García-Gasulla Dario, Ferrer Ricard, Riera Jordi, Lorente José Ángel, Peñuelas Óscar, Bermejo-Martin Jesús F, de Gonzalo-Calvo David, Rodríguez Alejandro, Barbé Ferran, Aguilera Luciano, Amaya-Villar Rosario, Barberà Carme, Barberán José, Blandino Ortiz Aaron, Bustamante-Munguira Elena, Caballero Jesús, Carbajales Cristina, Carbonell Nieves, Catalán-González Mercedes, Galbán Cristóbal, Gumucio-Sanguino Víctor D, de la Torre Maria Del Carmen, Díaz Emili, Gallego Elena, García Garmendia José Luis, Garnacho-Montero José, Gómez José M, Jorge García Ruth Noemí, Loza-Vázquez Ana, Marín-Corral Judith, Martínez de la Gándara Amalia, Martínez Varela Ignacio, Lopez Messa Juan, Albaiceta Guillermo M, Novo Mariana Andrea, Peñasco Yhivian, Ricart Pilar, Urrelo-Cerrón Luis, Sánchez-Miralles Angel, Sancho Chinesta Susana, Socias Lorenzo, Solé-Violan Jordi, Tamayo Lomas Luis, Vidal Pablo, Torres Antoni
CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, 28029 Madrid, Spain.
Pulmonary Department, Hospital Clinic, Universitat de Barcelona, IDIBAPS, 08036 Barcelona, Spain.
J Clin Med. 2021 Dec 31;11(1):224. doi: 10.3390/jcm11010224.
Some patients previously presenting with COVID-19 have been reported to develop persistent COVID-19 symptoms. While this information has been adequately recognised and extensively published with respect to non-critically ill patients, less is known about the incidence and factors associated with the characteristics of persistent COVID-19. On the other hand, these patients very often have intensive care unit-acquired pneumonia (ICUAP). A second infectious hit after COVID increases the length of ICU stay and mechanical ventilation and could have an influence on poor health post-COVID 19 syndrome in ICU-discharged patients.
This prospective, multicentre, and observational study was carrid out across 40 selected ICUs in Spain. Consecutive patients with COVID-19 requiring ICU admission were recruited and evaluated three months after hospital discharge.
A total of 1255 ICU patients were scheduled to be followed up at 3 months; however, the final cohort comprised 991 (78.9%) patients. A total of 315 patients developed ICUAP (97% of them had ventilated ICUAP). Patients requiring invasive mechanical ventilation had more persistent post-COVID-19 symptoms than those who did not require mechanical ventilation. Female sex, duration of ICU stay, development of ICUAP, and ARDS were independent factors for persistent poor health post-COVID-19.
Persistent post-COVID-19 symptoms occurred in more than two-thirds of patients. Female sex, duration of ICU stay, development of ICUAP, and ARDS all comprised independent factors for persistent poor health post-COVID-19. Prevention of ICUAP could have beneficial effects in poor health post-COVID-19.
据报道，一些曾感染新型冠状病毒肺炎（COVID-19）的患者会出现持续性COVID-19症状。虽然这一信息已在非危重症患者中得到充分认识并广泛发表，但关于持续性COVID-19特征的发生率及相关因素却知之甚少。另一方面，这些患者经常发生重症监护病房获得性肺炎（ICUAP）。COVID感染后的二次感染打击会增加重症监护病房住院时间和机械通气时间，并可能影响ICU出院患者COVID-19后综合征的健康状况。
这项前瞻性、多中心观察性研究在西班牙40家选定的重症监护病房开展。连续纳入需要入住重症监护病房的COVID-19患者，并在出院三个月后进行评估。
共有1255名重症监护病房患者计划在3个月时进行随访；然而，最终队列包括991名（78.9%）患者。共有315名患者发生了ICUAP（其中97%为有创机械通气相关的ICUAP）。需要有创机械通气的患者比不需要机械通气的患者有更多持续性COVID-19后症状。女性、重症监护病房住院时间、ICUAP的发生以及急性呼吸窘迫综合征（ARDS）是COVID-19后持续健康状况不佳的独立因素。
超过三分之二的患者出现了持续性COVID-19后症状。女性、重症监护病房住院时间、ICUAP的发生以及ARDS均为COVID-19后持续健康状况不佳的独立因素。预防ICUAP可能对COVID-19后的健康状况不佳有有益影响。
