Page 225 - Livre électronique des RFTP 2024

PULMONARY FUNCTION AND FUNCTIONAL

CAPACITY IN POST-COVID-19 ICU SURVIVORS AT ONE
YEAR POST DISCHARGE

NADIA BEN LAZREG1,2 MARWA ZGUIDI 3, MARIEM ABDESSLEM1,2, FATMA GUEZGUEZ,
1,2, SONIA ROUATBI,1,2

1UNIVERSITE DE SOUSSE, HOPITAL FARHAT HACHED, SERVICE DE PHYSIOLOGIE ET
EXPLORATIONS FONCTIONNELLES, SOUSSE,TUNISIE. 2UNIVERSITE DE SOUSSE, HOPITAL
FARHAT HACHED, LABORATOIRE DE RECHERCHE « L’INSUFFISANCE CARDIAQUE » (LR12SP09),
SOUSSE, TUNISIE. 3UNIVERSITE DE SOUSSE, HOPITAL FARHAT HACHED, SERVICE DE
REANIMATION MEDICALE, SOUSSE, TUNISIE

INTRODUCTION The COVID-19 pandemic had a notable proportion of patients
requiring intensive care unit (ICU) admission and invasive mechanical ventilation
(IMV). Data about pulmonary function and functional capacity one year following
COVID-19 are scarce. Thus, it is imperative to determine the persistence of long-
terms impairments in pulmonary function and functional capacity. Aim: To evaluate
the pulmonary function and the functional capacity in post-COVID-19 patients at
one year post ICU discharge, to identify the risk factors and the correlations of their
impairments.

METHODS: It was a prospective observational study including patients admitted to
a medical ICU for a severe to critical COVID-19 between March 2020 and
December 2021, for ≥ 48 hours and who were discharged alive. One year after ICU
discharge, participants underwent an evaluation by Body plethysmography, lung
diffusion capacity (DLCO), Maximal expiratory pressure (PEmax), maximal
inspiratory pressure (PImax) 6-min walk test (6MWT),and Short Physical
Performance Battery (SPPB).

RESULTS: 465 patients had confirmed COVID-19 infection, 175 (37.6%) died. Among
the 290 survivors, 14 (4.8%) died after ICU discharge, 104 (35,8%) were unreachable
or refused to participate, 36 (12.4%) patients were included.

Patient characteristics in the ICU: Median age, 56 [49-65] years; Male-to-female
ratio, 2.6. Median SAPSII score on admission, 27 [26-30]; High-flow oxygen therapy,
36 (100%) patients; Invasive mechanical ventilation, 8 (22.2%) patients; Ground glass
opacities, 35 (99%) patients; Extensive lesions, 14 (40%) cases; and median ICU
length of stay, 8 [5-12] days.

One year after discharge, 15 (43%) participants reported dyspnea. Median 6 minutes
walked distance(6MWD), 541 [494-617] m, corresponding to 95 [89-111] % of the
predicted value. Median SPPB score, 10 [9-11], reduced physical performance (total
SPPB≤9), 9(25%). SPBB balance score <4, 6(16%) patients; SPBB Gait speed score,
<4, 5(13.8%) patients; SPBB standing from a chair score <4, 19(52.7%) patients. Age
(65 [58-72] years vs 55 [46-62] years, 0.002), IMV use (33.3% vs 13.8, 0.045), and CCI
(2[1-3] vs1[0-2],0.033) were significant predictors of reduced physical performance

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