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Evaluation of Long-Coronavirus Disease 2019 Cases Readmitted to Intensive Care Units Due to Acute Respiratory
Eylem Tunçay1, Özlem Moçin2, Özlem Ediboğdu3
1Department of Intensive Care, University of Medical Sciences Şehit Prof. Dr. İlhan Varank Training and Research Hospital, İstanbul, Turkey.
Insights
Long-COVID patients admitted to the intensive care unit (ICU) often present with pneumonia, comorbidities, and high severity scores. These factors, along with corticosteroid use and extensive lung involvement, may contribute to frequent ICU readmissions.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Pulmonology
Background:
- Coronavirus disease 2019 (COVID-19) has caused significant global morbidity and mortality.
- Long-COVID, characterized by subacute and long-term effects, contributes to ongoing health burdens.
- Intensive care unit (ICU) data provides crucial insights into severe COVID-19 outcomes.
Purpose of the Study:
- To evaluate intensive care unit (ICU) data from patients diagnosed with long-COVID.
- To identify characteristics and outcomes of long-COVID patients requiring critical care.
- To understand factors associated with severe disease in long-COVID survivors.
Main Methods:
- A multicenter point prevalence study involving 11 centers.
- Inclusion of patients diagnosed with long-COVID and managed in the ICU.
- Analysis of demographic, clinical, and radiological data.
Main Results:
- 41 long-COVID patients (mean age 66±14, 50% male) were analyzed.
- High rates of comorbidities (hypertension 27%, diabetes 51%) and malignancies (34%) were observed.
- Moderate hypoxemic respiratory failure, high severity scores (APACHE II 18, SOFA 6), and significant rates of mechanical ventilation (46%) and sepsis (42%) were noted.
- Chest imaging revealed bilateral (67%) and interstitial (37%) involvement, with 27% showing fibrosis.
- 71% received broad-spectrum antibiotics, and 61% received corticosteroid treatment.
Conclusions:
- A significant proportion of ICU patients with long-COVID had pneumonia and required broad-spectrum antibiotics.
- High rates of comorbidities, malignancies, severe illness scores, intubation, and sepsis were identified.
- Corticosteroid treatment and extensive bilateral lung involvement may be associated with high ICU readmission rates for long-COVID patients.
Objective:
Coronavirus disease 2019 (COVID-19) caused morbidity and mortality worldwide. Besides the acute effects, subacute and long-term effects are defined as long-COVID causing morbidity. The intensive care unit (ICU) data of long-COVID-19 cases were evaluated with the participation of 11 centers.
Material And Methods:
Study was designed by Turkish Thoracic Society Respiratory Failure and Intensive Care Working Group to evaluate long COVID-19 patients. All patients followed up in the ICU with long-COVID diagnosis were included in point prevelance study.
Results:
A total of 41 long COVID-19 patients from 11 centers were included in the study. Half of the patients were male, mean age was 66 ± 14, body mass index was 27 ± 5. Hypertension, diabetes mellitus, lung cancer, malignancy, and heart failure rates were 27%, 51%, 34%, 34%, and 27%, respectively. Eighty percent had received COVID vaccine. Patients had moderate hypoxemic respiratory failure. APACHE II, SOFA score was 18 (14-26), 6 (3-8), respectively. Forty-six percent received invasive mechanical ventilator support, 42% were sepsis, 17% were septic shock. Bilateral (67%), interstitial involvement (37%) were most common in chest x-ray. Fibrosis (27%) was detected in thorax tomography. Seventy-one percent of patients received antibiotherapy (42% carbapenem, 22% linezolid). Sixty-one percent of the patients received corticosteroid treatment.
Conclusion:
More than half of the patients had pneumonia and the majority of them used broad-spectrum antibiotics. Presence of comorbidities and malignancies, intensive care severity scores, intubation, and sepsis rates were high. Receiving corticosteroid treatment and extensive bilateral radiologic involvement due to COVID-19 might be the reasons for the high re-admission rate for the ICUs.
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