• Moreno Tresoldi, Alberto Zangrillo, Alessandro Belletti, Giuseppe A Ramirez, Enrica Bozzolo, Francesca Guzzo, Alessandro Marinosci, Evgeny V Fominskiy, Valentina DA Prat, Marilena Marmiere, Diego Palumbo, Lidia Del Prete, Filippo D'Amico, Chiara Bellino, Deodata Morando, Marco Saracino, Alessandro Ortalda, Elena Castelli, Margherita Rocchi, Martina Baiardo Redaelli, Raffaella Scotti, Gaetano DI Terlizzi, Maria L Azzolini, Giulia Guaschino, Emma Avitabile, Giovanni Borghi, Daniele Soddu, Lorenzo Dagna, Giovanni Landoni, Francesco DE Cobelli, and COVID-BioB Study Group.
• Unit of General Medicine and Advanced Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.
• Minerva Med. 2023 Dec 1; 114 (6): 773784773-784.

BackgroundCOVID-19 patients frequently develop respiratory failure requiring mechanical ventilation. Data on long-term survival of patients who had severe COVID-19 are insufficient. We assessed and compared two-year survival, CT imaging, quality of life, and functional recovery of COVID-19 ARDS patients requiring respiratory support with invasive (IMV) versus noninvasive ventilation (NIV).MethodsPatients with COVID-19 pneumonia admitted up to May 28th, 2020, who required IMV or NIV, and survived to hospital discharge were enrolled. Patients were contacted two years after discharge to assess vital status, functional, psychological, and cognitive outcomes using validated scales. Patients with persistent respiratory symptoms or high burden of residual lung damage at previous CT scan received a two-year chest CT scan.ResultsOut of 61 IMV survivors, 98% were alive at two-year follow-up, and 52 completed the questionnaire. Out of 82 survivors receiving NIV only, 94% were alive at two years, and 47 completed the questionnaire. We found no major differences between invasively and noninvasively ventilated patients, with overall acceptable functional recovery. Among the 99 patients completing the questionnaire, 23 have more than moderate exertional dyspnea. Chest CT scans showed that 4 patients (all received IMV) had fibrotic-like changes.ConclusionsPatients who received mechanical ventilation due to COVID-19 and were discharged from hospital had a 96% survival rate at the two-year follow-up. There was no difference in overall recovery and quality of life between patients who did and did not require IMV, although respiratory morbidity remains high.

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