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Published on: December 19, 2020
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Fibrotic-Like Pulmonary Radiographic Patterns Are Not Associated With Adverse Outcomes in COVID-19 Chronic Critical
Purnema Madahar1, Kathleen M Capaccione2, Mary M Salvatore2
1Division of Pulmonary, Allergy, and Critical Care, Columbia University Vagelos College of Physicians and Surgeons/New York Presbyterian, New York, NY.
Critical Care Medicine
|June 9, 2023
Summary
Pulmonary fibrosis is a feared complication of COVID-19. This study found that approximately half of patients with severe COVID-19 and chronic critical illness developed fibrotic-like lung patterns, associated with higher IL-6 levels but not worse survival.
Area of Science:
- Pulmonology
- Critical Care Medicine
- Infectious Diseases
Background:
- Pulmonary fibrosis is a significant concern following COVID-19.
- COVID-19-related acute respiratory distress syndrome (ARDS) can lead to chronic critical illness.
- Characterizing fibrotic changes in these patients is crucial for understanding outcomes.
Purpose of the Study:
- To investigate the prevalence of fibrotic-like radiographic abnormalities in patients with COVID-19-related ARDS and chronic critical illness.
- To identify risk factors and clinical characteristics associated with these fibrotic patterns.
- To determine the impact of fibrotic patterns on mechanical ventilator liberation and 6-month survival.
Main Methods:
- A single-center prospective cohort study was conducted.
- Chest CT scans of adult patients with COVID-19-related ARDS and chronic critical illness were analyzed.
- Fibrotic-like patterns were quantified, and associations with clinical data and biomarkers were assessed.
Main Results:
- Of 141 patients with COVID-19-related ARDS and chronic critical illness, 46% showed fibrotic-like patterns on CT scans.
- Higher interleukin-6 levels at intubation were associated with fibrotic-like patterns.
- These patterns were not linked to prolonged mechanical ventilation or reduced 6-month survival.
Conclusions:
- Approximately 50% of critically ill COVID-19 patients exhibit fibrotic-like lung changes.
- Elevated interleukin-6 at intubation is a potential predictor of these fibrotic patterns.
- Fibrotic-like changes did not negatively impact ventilator liberation or long-term survival in this cohort.
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