One Year Overview and Follow-Up in a Post-COVID Consultation of Critically Ill Patients

Jessica González; María Zuil; Iván D Benítez; David de Gonzalo-Calvo; María Aguilar; Sally Santisteve; Rafaela Vaca; Olga Minguez; Faty Seck; Gerard Torres; Jordi de Batlle; Silvia Gómez; Silvia Barril; Anna Moncusí-Moix; Aida Monge; Clara Gort-Paniello; Ricard Ferrer; Adrián Ceccato; Laia Fernández; Ana Motos; Jordi Riera; Rosario Menéndez; Darío Garcia-Gasulla; Oscar Peñuelas; Gonzalo Labarca; Jesús Caballero; Carme Barberà; Antoni Torres; Ferran Barbé

doi:10.3389/fmed.2022.897990

One Year Overview and Follow-Up in a Post-COVID Consultation of Critically Ill Patients

Front Med (Lausanne). 2022 Jul 14:9:897990. doi: 10.3389/fmed.2022.897990. eCollection 2022.

Authors

Jessica González^{1

2

3

4}, María Zuil^{1

2

3

4}, Iván D Benítez^{2

3

4}, David de Gonzalo-Calvo^{2

3

4}, María Aguilar^{1

2}, Sally Santisteve^{1

2

3

4}, Rafaela Vaca^{1

2}, Olga Minguez^{1

2}, Faty Seck^{1

2}, Gerard Torres^{1

2

3

4}, Jordi de Batlle^{2

3

4}, Silvia Gómez^{1

2

3

4}, Silvia Barril^{1

2

3

4}, Anna Moncusí-Moix^{2

3

4}, Aida Monge^{1

2

3

4}, Clara Gort-Paniello^{2

3

4}, Ricard Ferrer^{4

5}, Adrián Ceccato⁴, Laia Fernández^{4

6}, Ana Motos^{4

6}, Jordi Riera^{4

5}, Rosario Menéndez^{4

7}, Darío Garcia-Gasulla⁸, Oscar Peñuelas^{4

9}, Gonzalo Labarca^{10

11}, Jesús Caballero¹², Carme Barberà¹³, Antoni Torres^{4

6}, Ferran Barbé^{1

2

3

4}

Affiliations

¹ Department of Pulmonary, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, Spain.
² Translational Research in Respiratory Medicine Group, Lleida, Spain.
³ Lleida Biomedical Research Institute, Lleida, Spain.
⁴ Centro de Investigación Biomédica en Red (CIBER) of Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain.
⁵ Intensive Care Department, Vall d'Hebron Hospital Universitari, Shock, Organ Dysfunction and Resuscitation (SODIR) Research Group, Vall d'Hebron Institut de Recerca, Barcelona, Spain.
⁶ Department of Pulmonary, Hospital Clinic, Universitat de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
⁷ Department of Pulmonary, University and Polytechnic Hospital La Fe, Valencia, Spain.
⁸ Barcelona Supercomputing Center, Barcelona, Spain.
⁹ Hospital Universitario de Getafe, Madrid, Spain.
¹⁰ Faculty of Medicine, University of Concepción, Concepción, Chile.
¹¹ Department of Clinical Biochemistry and Immunology, Faculty of Pharmacy, Concepción, Chile.
¹² Intensive Care Department, Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain.
¹³ Intensive Care Department, Hospital Universitari Santa Maria de Lleida, Lleida, Spain.

Abstract

The long-term clinical management and evolution of a cohort of critical COVID-19 survivors have not been described in detail. We report a prospective observational study of COVID-19 patients admitted to the ICU between March and August 2020. The follow-up in a post-COVID consultation comprised symptoms, pulmonary function tests, the 6-minute walking test (6MWT), and chest computed tomography (CT). Additionally, questionnaires to evaluate the prevalence of post-COVID-19 syndrome were administered at 1 year. A total of 181 patients were admitted to the ICU during the study period. They were middle-aged (median [IQR] of 61 [52;67]) and male (66.9%), with a median ICU stay of 9 (5-24.2) days. 20% died in the hospital, and 39 were not able to be included. A cohort of 105 patients initiated the follow-up. At 1 year, 32.2% persisted with respiratory alterations and needed to continue the follow-up. Ten percent still had moderate/severe lung diffusion (DLCO) involvement (<60%), and 53.7% had a fibrotic pattern on CT. Moreover, patients had a mean (SD) number of symptoms of 5.7 ± 4.6, and 61.3% met the criteria for post-COVID syndrome at 1 year. During the follow-up, 46 patients were discharged, and 16 were transferred to other consultations. Other conditions, such as emphysema (21.6%), COPD (8.2%), severe neurocognitive disorders (4.1%), and lung cancer (1%) were identified. A high use of health care resources is observed in the first year. In conclusion, one-third of critically ill COVID-19 patients need to continue follow-up beyond 1 year, due to abnormalities on DLCO, chest CT, or persistent symptoms.

Keywords: COVID-19; CT abnormalities; SARS; SARS-CoV-2; intensive care unit (ICU); lung function; post-COVID syndrome; sequelae.

Copyright © 2022 González, Zuil, Benítez, de Gonzalo-Calvo, Aguilar, Santisteve, Vaca, Minguez, Seck, Torres, de Batlle, Gómez, Barril, Moncusí-Moix, Monge, Gort-Paniello, Ferrer, Ceccato, Fernández, Motos, Riera, Menéndez, Garcia-Gasulla, Peñuelas, Labarca, Caballero, Barberà, Torres and Barbé.