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Observational Study
. 2022 May;36(5):1354-1363.
doi: 10.1053/j.jvca.2021.11.032. Epub 2021 Nov 27.

One-Year Multidisciplinary Follow-Up of Patients With COVID-19 Requiring Invasive Mechanical Ventilation

Alberto Zangrillo  1 , Alessandro Belletti  2 , Diego Palumbo  3 , Maria Rosa Calvi  2 , Francesca Guzzo  2 , Evgeny V Fominskiy  2 , Alessandro Ortalda  2 , Pasquale Nardelli  2 , Marco Ripa  4 , Martina Baiardo Redaelli  2 , Giovanni Borghi  2 , Giovanni Landoni  5 , Filippo D'Amico  2 , Marilena Marmiere  2 , Beatrice Righetti  2 , Margherita Rocchi  2 , Marco Saracino  2 , Moreno Tresoldi  6 , Lorenzo Dagna  7 , Francesco De Cobelli  8 ; COVID-BioB Study Group
Affiliations
Observational Study

One-Year Multidisciplinary Follow-Up of Patients With COVID-19 Requiring Invasive Mechanical Ventilation

Alberto Zangrillo et al. J Cardiothorac Vasc Anesth. 2022 May.

Abstract

Objectives: Patients with COVID-19 frequently develop acute respiratory distress syndrome (ARDS) requiring intensive care unit (ICU) admission. Data on long-term survival of these patients are lacking. The authors investigated 1-year survival, quality of life, and functional recovery of patients with COVID-19 ARDS requiring invasive mechanical ventilation.

Design: Prospective observational study.

Setting: Tertiary-care university hospital.

Participants: All patients with COVID-19 ARDS receiving invasive mechanical ventilation and discharged alive from hospital.

Interventions: Patients were contacted by phone after 1 year. Functional, cognitive, and psychological outcomes were explored through a questionnaire and assessed using validated scales. Patients were offered the possibility to undergo a follow-up chest computed tomography (CT) scan.

Measurements and main results: The study included all adult (age ≥18 years) patients with COVID-19-related ARDS admitted to an ICU of the authors' institution between February 25, 2020, and April 27, 2020, who received at least 1 day of invasive mechanical ventilation (IMV). Of 116 patients who received IMV, 61 (52.6%) survived to hospital discharge. These survivors were assessed 1 year after discharge and 56 completed a battery of tests of cognition, activities of daily living, and interaction with family members. They had overall good functional recovery, with >80% reporting good recovery and no difficulties in usual activities. A total of 52 (93%) of patients had no dyspnea at rest. Severe anxiety/depression was reported by 5 (8.9%) patients. Comparing 2-month and 1-year data, the authors observed the most significant improvements in the areas of working status and exertional dyspnea. One-year chest CT scans were available for 36 patients; fibrotic-like changes were present in 4 patients.

Conclusions: All patients who survived the acute phase of COVID-19 and were discharged from the hospital were alive at the 1-year follow up, and the vast majority of them had good overall recovery and quality of life.

Keywords: acute respiratory distress syndrome; coronavirus disease 2019; intensive care unit; lung recovery; post-intensive care syndrome; pulmonary fibrosis; quality of life.

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Conflict of interest statement

Conflict of Interest None.

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Flow diagram showing the screening to follow-up.
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