Six-Month Outcome in Survivors of COVID-19 Associated Acute Respiratory Distress Syndrome

Abstract

BACKGROUND: Survivors of acute respiratory distress syndrome (ARDS) frequently experience long-lasting physical, cognitive and mental impairments. We aimed to characterize persisting disabilities in survivors of COVID-19-associated ARDS at three and six months after hospital discharge.METHODS: Patients were assessed serially with a structured telephone interview, complete clinical chart and X-ray review and in-person visit at a follow-up clinic.FINDINGS: Of the 93 survivors, 3 (3%) were lost to follow-up, 8 (8%) were totally dependent and 82 were independent in activities of daily living (ADL). Of these 82 patients, 25 had reached independence at hospital discharge and refused further evaluation, whereas 57 consented to participate in the follow-up visit at 3 months and 45 at 6 months. Muscle strength, performance-based and self reported measures of physical activity and measures of participation in ADL were normal at 6 months, but severe fatigue was common (36%) and remained unchanged over time. Cognitive and mental function were normal or only mildly impaired in most patients. At 6 months, the median physical and mental component summaries of the SF-36 were 100% of predicted values, and all patients were independent in ADL. Chest X-ray and pulmonary function were altered in a considerable proportion of patients at 3 months, but very few patients had persisting respiratory symptoms at 6 months.INTERPRETATION: Survivors of COVID-19-associated ARDS have fast recovery of physical functioning at the body level, of the whole person and as participation in a social context. Cognitive and mental function, quality of life and independence in ADL are also rapidly re-established.TRIAL REGISTRATION: NCT04608994FUNDING STATEMENT: The study was funded by FONDAZIONE ALESSANDRA BONO ONLUS, a non-profit organization - Via Fornaci 33, 25040 Corte Franca (BS), Italy https://www.fondazionealessandrabono.itDECLARATION OF INTERESTS: All authors declare no conflicts of interest.ETHICS APPROVAL STATEMENT: The Brescia Ethics committee approved the study (NP 2595).