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Six-Month Outcome in Survivors of COVID-19 Associated Acute Respiratory Distress Syndrome

43 Pages Posted: 29 Dec 2020

See all articles by Nicola Latronico

Nicola Latronico

ASST-Spedali Civili of Brescia - Intensive Care and Emergency; University of Brescia - Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health

Elena Peli

ASST-Spedali Civili of Brescia - Intensive Care and Emergency

Federica Rodella

ASST-Spedali Civili of Brescia - Intensive Care and Emergency

Maria Paola Novelli

ASST-Spedali Civili of Brescia - Intensive Care and Emergency

Frank Antony Rasulo

University of Brescia - Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health

Simone Piva

ASST-Spedali Civili of Brescia - Intensive Care and Emergency

LOTO Research Center

More...

Abstract

BACKGROUND: Survivors of acute respiratory distress syndrome (ARDS) frequently experience long-lasting physical, cognitive and mental impairments. We aimed to characterize persisting disabilities in survivors of COVID-19-associated ARDS at three and six months after hospital discharge.

METHODS: Patients were assessed serially with a structured telephone interview, complete clinical chart and X-ray review and in-person visit at a follow-up clinic.

FINDINGS: Of the 93 survivors, 3 (3%) were lost to follow-up, 8 (8%) were totally dependent and 82 were independent in activities of daily living (ADL). Of these 82 patients, 25 had reached independence at hospital discharge and refused further evaluation, whereas 57 consented to participate in the follow-up visit at 3 months and 45 at 6 months. Muscle strength, performance-based and self reported measures of physical activity and measures of participation in ADL were normal at 6 months, but severe fatigue was common (36%) and remained unchanged over time. Cognitive and mental function were normal or only mildly impaired in most patients. At 6 months, the median physical and mental component summaries of the SF-36 were 100% of predicted values, and all patients were independent in ADL. Chest X-ray and pulmonary function were altered in a considerable proportion of patients at 3 months, but very few patients had persisting respiratory symptoms at 6 months.

INTERPRETATION: Survivors of COVID-19-associated ARDS have fast recovery of physical functioning at the body level, of the whole person and as participation in a social context. Cognitive and mental function, quality of life and independence in ADL are also rapidly re-established.

TRIAL REGISTRATION: NCT04608994

FUNDING STATEMENT: The study was funded by FONDAZIONE ALESSANDRA BONO ONLUS, a non-profit organization - Via Fornaci 33, 25040 Corte Franca (BS), Italy https://www.fondazionealessandrabono.it

DECLARATION OF INTERESTS: All authors declare no conflicts of interest.

ETHICS APPROVAL STATEMENT: The Brescia Ethics committee approved the study (NP 2595).

Keywords: ARDS, COVID-19, Post-intensive Care Syndrome, disability, fatigue.

Suggested Citation

Latronico, Nicola and Peli, Elena and Rodella, Federica and Novelli, Maria Paola and Rasulo, Frank Antony and Piva, Simone and Center, LOTO Research, Six-Month Outcome in Survivors of COVID-19 Associated Acute Respiratory Distress Syndrome. Available at SSRN: https://ssrn.com/abstract=3756865 or http://dx.doi.org/10.2139/ssrn.3756865

Nicola Latronico (Contact Author)

ASST-Spedali Civili of Brescia - Intensive Care and Emergency ( email )

Italy
+39-0303995561 (Phone)
+39-0303995779 (Fax)

University of Brescia - Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health ( email )

Piazza del Mercato
Brescia
Italy

Elena Peli

ASST-Spedali Civili of Brescia - Intensive Care and Emergency ( email )

Italy

Federica Rodella

ASST-Spedali Civili of Brescia - Intensive Care and Emergency ( email )

Italy

Maria Paola Novelli

ASST-Spedali Civili of Brescia - Intensive Care and Emergency ( email )

Italy

Frank Antony Rasulo

University of Brescia - Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health ( email )

Piazza del Mercato
Brescia
Italy

Simone Piva

ASST-Spedali Civili of Brescia - Intensive Care and Emergency

Italy

No contact information is available for LOTO Research Center

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