• Jessica González, Iván D Benítez, Paola Carmona, Sally Santisteve, Aida Monge, Anna Moncusí-Moix, Clara Gort-Paniello, Lucía Pinilla, Amara Carratalá, María Zuil, Ricard Ferrer, Adrián Ceccato, Laia Fernández, Ana Motos, Jordi Riera, Rosario Menéndez, Dario Garcia-Gasulla, Oscar Peñuelas, Jesús F Bermejo-Martin, Gonzalo Labarca, Jesus Caballero, Gerard Torres, David de Gonzalo-Calvo, Antoni Torres, Ferran Barbé, and CIBERESUCICOVID Project (COV20/00110, ISCIII).
• Pulmonary Department, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, Spain; Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain; Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.
• Chest. 2021 Jul 1; 160 (1): 187198187-198.

BackgroundMore than 20% of hospitalized patients with COVID-19 demonstrate ARDS requiring ICU admission. The long-term respiratory sequelae in such patients remain unclear.Research QuestionWhat are the major long-term pulmonary sequelae in critical patients who survive COVID-19?Study Design And MethodsConsecutive patients with COVID-19 requiring ICU admission were recruited and evaluated 3 months after hospitalization discharge. The follow-up comprised symptom and quality of life, anxiety and depression questionnaires, pulmonary function tests, exercise test (6-min walking test [6MWT]), and chest CT imaging.ResultsOne hundred twenty-five patients admitted to the ICU with ARDS secondary to COVID-19 were recruited between March and June 2020. At the 3-month follow-up, 62 patients were available for pulmonary evaluation. The most frequent symptoms were dyspnea (46.7%) and cough (34.4%). Eighty-two percent of patients showed a lung diffusing capacity of less than 80%. The median distance in the 6MWT was 400 m (interquartile range, 362-440 m). CT scans showed abnormal results in 70.2% of patients, demonstrating reticular lesions in 49.1% and fibrotic patterns in 21.1%. Patients with more severe alterations on chest CT scan showed worse pulmonary function and presented more degrees of desaturation in the 6MWT. Factors associated with the severity of lung damage on chest CT scan were age and length of invasive mechanical ventilation during the ICU stay.InterpretationThree months after hospital discharge, pulmonary structural abnormalities and functional impairment are highly prevalent in patients with ARDS secondary to COVID-19 who required an ICU stay. Pulmonary evaluation should be considered for all critical COVID-19 survivors 3 months after discharge.Copyright © 2021 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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