Berger Marie, Daubin Delphine, Charriot Jeremy, Klouche Kada, Le Moing Vincent, Morquin David, Halimi Laurence, Jaussent Audrey, Taourel Patrice, Hayot Maurice, Cristol Jean-Paul, Nagot Nicolas, Fesler Pierre, Roubille Camille
Department of Internal Medicine, Montpellier University Hospital, 34090 Montpellier, France.
Critical Care Unit, Montpellier University Hospital, 34090 Montpellier, France.
J Clin Med. 2023 Jan 28;12(3):1000. doi: 10.3390/jcm12031000.
The objective of this prospective, single-center study was to explore the mid-term outcomes 6 to 9 months after hospitalization in an Intensive Care Unit (ICU) for severe COVID-19 infection.
Patients systematically underwent biological tests, pulmonary function tests, chest computed tomography (CT) scan, and psychological tests.
Among 86 patients, including 71 (82.6%) men, median age of 65.8 years (56.7; 72.4), 57 (71.3%) patients presented post-COVID-19 asthenia, 39 (48.1%) muscle weakness, and 30 (36.6%) arthralgia. Fifty-two (64.2%) patients had a decreased diffusion capacity for carbon monoxide (DLCO) <80% and 16 (19.8%) had DLCO <60%. Chest CT-scans showed ground glass opacities in 35 (40.7%) patients, and reticular changes in 28 patients (33.7%), including fibrosis-like changes in 18 (21.7%) patients. Reticular changes and DLCO <60% were associated with length of stay in ICU, and reticular changes with higher maximal CRP level. The psychological questionnaires found 37.7% suffered from depression, 23.5% from anxiety, 42.4% from insomnia, and 9.4% from post-traumatic stress. Being female was associated with a higher frequency of depression and anxiety, with depression scores being associated with obesity.
Many patients hospitalized in ICU for severe COVID-19 infection have mid-term sequelae. Additional studies on the prognostic factors seem necessary.
本前瞻性单中心研究的目的是探讨重症新型冠状病毒肺炎(COVID-19)感染患者在重症监护病房(ICU)住院6至9个月后的中期结局。
患者系统地接受了生物学检查、肺功能检查、胸部计算机断层扫描(CT)以及心理测试。
86例患者中,包括71例(82.6%)男性,中位年龄65.8岁(56.7;72.4),57例(71.3%)患者出现COVID-19后乏力,39例(48.1%)肌肉无力,30例(36.6%)关节痛。52例(64.2%)患者一氧化碳弥散量(DLCO)降低<80%,16例(19.8%)DLCO<60%。胸部CT扫描显示35例(40.7%)患者有磨玻璃影,28例(33.7%)患者有网状改变,其中18例(21.7%)患者有类似纤维化的改变。网状改变和DLCO<60%与ICU住院时间相关,网状改变与最高C反应蛋白(CRP)水平较高相关。心理问卷显示,37.7%的患者患有抑郁症,23.5%患有焦虑症,42.4%患有失眠症,9.4%患有创伤后应激障碍。女性与抑郁症和焦虑症的较高发生率相关,抑郁评分与肥胖相关。
许多因重症COVID-19感染入住ICU的患者有中期后遗症。似乎有必要对预后因素进行更多研究。