FOLLOW-UP OF PATIENTS WITH SEVERE COVID-19 PNEUMONIA AND TORPID EVOLUTION

Abstract

It is unknown whether patients with SARS-CoV2 pneumonia and non-invasive respiratory support (NIRS) who have experienced a torpid course during hospitalization can have pulmonary sequelae.

To describe the evolution of patients with SARS-CoV-2 pneumonia who required NIRS and torpid clinical evolution during hospitalization.

All patients admitted to a tertiary hospital (between 10 March-15 April 2020) and discharged with a diagnosis of SARS-CoV-2 pneumonia and NIRS, were reviewed retrospectively. The patients were classified into two groups: those patients who had presented a torpid evolution, defined as persistence of respiratory failure and those of favorable evolution. The patients with torpid evolution were visited in the post-COVID Unit (3 months after discharge) with symptoms evaluation, CT scan, pulmonary function test, 6-minute walk test (6MWT); and the patients with favorable evolution with symptoms evaluation trough a checklist by phone.

Twenty-seven of the 31 patients who presented torpid evolution were evaluated; of the 60 patients in the favorable group, 20 patients required evaluation for dyspnea. All patients in the torpid group had HRCT abnormalities, especially ground glass opacities, reticulation, and traction bronchiectasis. The patients in the torpid group, compared to the favorable group, had a lower DLco (% pred.) [62 vs. 75; p = 0.006] with no difference in FVC (% pred.) [81 vs. 80; p = 0.838]. The minimum Sp02 in 6MWT was lower in the torpid group than in the favorable group.

Patients who have presented a torpid course during hospitalization for SARS-CoV-2 pneumonia have interstitial abnormalities in CT scan and moderate impairment in DLco, in the medium term.