ICU-Acquired Pneumonia Is Associated with Poor Health Post-COVID-19 Syndrome
Ignacio Martín‐Loeches, Ana Motos, Rosario Menéndez, Albert Gabarrús, Jessica González, Laia Fernández‐Barat, Adrián Ceccato, Raquel Pérez-Arnal, Dario García-Gasulla, Ricard Ferrer, Jordi Riera, José A. Lorente, Óscar Peñuelas, Jesús F. Bermejo-Martín, David de Gonzalo‐Calvo, Alejandro Rodríguez, Ferrán Barbé, Luciano Aguilera, Rosario Amaya‐Villar, Carme Barberà, José Barberán, Aaron Blandino Ortíz, Elena Bustamante‐Munguira, Jesús Caballero, Cristina Carbajales, Nieves Carbonell, Mercedes Catalán-González, Cristóbal Galbán‐Malagón, Víctor D. Gumucio-Sanguino, Maria de la Torre, Emili Dı́az, Elena Gallego, J.L. García Garmendia, José Garnacho‐Montero, Jose M Gomez, Ruth Jorge García, Ana Loza-Vázquez, Judith Marín‐Corral, Amalia Martínez de la Gándara, Ignacio Martínez Varela, Juan López Messa, Guillermo M. Albaiceta, Mariana Andrea Novo, Yhivian Peñasco, Pilar Ricart, Luis Urrelo-Cerrón, Ángel Sánchez-Miralles, Susana Sancho Chinesta, Lorenzo Socías, Jordi Solé‐Violán, Luis Tamayo Lomas, Pablo Vidal, Antoní Torres
Abstract
BACKGROUND: Some patients previously presenting with COVID-19 have been reported to develop persistent COVID-19 symptoms. While this information has been adequately recognised and extensively published with respect to non-critically ill patients, less is known about the incidence and factors associated with the characteristics of persistent COVID-19. On the other hand, these patients very often have intensive care unit-acquired pneumonia (ICUAP). A second infectious hit after COVID increases the length of ICU stay and mechanical ventilation and could have an influence on poor health post-COVID 19 syndrome in ICU-discharged patients. METHODS: This prospective, multicentre, and observational study was carrid out across 40 selected ICUs in Spain. Consecutive patients with COVID-19 requiring ICU admission were recruited and evaluated three months after hospital discharge. RESULTS: A total of 1255 ICU patients were scheduled to be followed up at 3 months; however, the final cohort comprised 991 (78.9%) patients. A total of 315 patients developed ICUAP (97% of them had ventilated ICUAP). Patients requiring invasive mechanical ventilation had more persistent post-COVID-19 symptoms than those who did not require mechanical ventilation. Female sex, duration of ICU stay, development of ICUAP, and ARDS were independent factors for persistent poor health post-COVID-19. CONCLUSIONS: Persistent post-COVID-19 symptoms occurred in more than two-thirds of patients. Female sex, duration of ICU stay, development of ICUAP, and ARDS all comprised independent factors for persistent poor health post-COVID-19. Prevention of ICUAP could have beneficial effects in poor health post-COVID-19.