Long-term impact of COVID-19 associated acute respiratory distress syndrome

Aranda, Judit; Oriol, Isabel; Martín, Miguel; Feria, Lucía; Và zquez, Núria; Rhyman, Nicolás; Vall-Llosera, Estel; Pallarés, Natà lia; Coloma, Ana; Pestaña, Melani; Loureiro, Jose; Güell, Elena; Borjabad, Beatriz; León, Elena; Franz, Elena; Domènech, Anna; Pintado, Sara; Contra, Anna; Cortés, María del Señor; Chivite, Iván; Clivillé, Raquel; Vacas, Montserrat; Ceresuela, Luis Miguel; Carratalà , Jordi

OBJECTIVES: To determine the health status, exercise capacity, and health related quality of life (HRQoL) of COVID-19 associated acute respiratory distress syndrome (ARDS) survivors, 8 months after diagnosis. METHODS: All eligible patients were interviewed and underwent a physical examination, chest X-ray, and 6-minute walk test (6MWT). Scales to evaluate post-traumatic stress disorder, depression, anxiety, and HRQoL were applied. RESULTS: Of 1,295 patients, 365 suffered ARDS and 166 survived to hospital discharge. Five died after discharge and 48 were lost to follow-up. Of the 113 remaining patients, 81% had persistent symptoms. More than 50% of patients completed less than 80% of the theoretical distance on the 6MWT, 50% had an abnormal X-ray and 93% of patients developed psychiatric disorders. Mean SF-36 scores were worse than in the general population. After multivariate regression analysis, female sex, non-Caucasian race, and Charlson index>2 were independent risk factors for a worse mental health component summary score on the SF-36, and age was associated with a better prognosis. Female sex and chronic obstructive pulmonary disease were independently associated with a worse physical component summary score. CONCLUSION: COVID-19 associated ARDS survivors have long-term consequences in health status, exercise capacity, and HRQoL. Strategies addressed to prevent these sequelae are needed.