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Early sequelae of post COVID-19 lung disease in patients who were mechanically ventilated for severe COVID-19 pneumonia
Introduction: COVID-19 resulted in an unprecedented worldwide spike in hospital and ICU admissions; predominantly for adult respiratory distress syndrome (ARDS). Survival rates for patients requiring mechanical ventilation in Cape Town during the waves driven by the ancestral strain and beta variant...
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| Format: | Thesis |
| Language: | English |
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Department of Medicine
2024
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| _version_ | 1867613142994911232 |
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| access_status_str | Open Access |
| author | Singh, Nevadna |
| author2 | Van Zyl-Smit, Richard |
| author_browse | Singh, Nevadna Van Zyl-Smit, Richard |
| author_facet | Van Zyl-Smit, Richard Singh, Nevadna |
| author_sort | Singh, Nevadna |
| collection | Thesis |
| description | Introduction: COVID-19 resulted in an unprecedented worldwide spike in hospital and ICU admissions; predominantly for adult respiratory distress syndrome (ARDS). Survival rates for patients requiring mechanical ventilation in Cape Town during the waves driven by the ancestral strain and beta variant were approximately 30% during the first 3 waves of the pandemic. However, post-ICU admission sequelae and recovery trajectory in sub-Saharan Africa remain unknown. Methods: We systematically evaluated a cohort of COVID-19 ICU survivors at three months following hospital discharge. A retrospective single-centre study enrolled all COVID-19 pneumonia patients who were admitted to ICU for mechanical ventilation and followed up at the post-COVID-19 Lung Disease Clinic between 1 July 2020 and 30 December 2021. Results: A total of 26 patients were evaluated at 3 months after discharge from hospital following mechanical ventilation: 53% were male and 81% had at least one co-morbidity. Diabetes and hypertension were present in 42% and 54% of patients respectively. Persistent dyspnoea (89%) and fatigue (54%) were the most common post-COVID-19 symptoms. Median FEV1 and FVC were 73% (IQR 65-83) and 71% (IQR 61-77) of predicted values respectively, whilst median DLCO was 59% (IQR 41- 70) of predicted values. Abnormalities were confirmed in all patients (24/26) who underwent high resolution computer tomography (HRCT) of the chest, with ground glass opacities (46%) and interstitial thickening (58%) being most common. No significant risk factors for post-COVID-19 impairment were identified. Conclusion: At 3 months after hospitalization, patients who received mechanical ventilation for COVID-19 pneumonia frequently reported ongoing symptoms. Lung function was moderately impaired with a disproportionate reduction in DLCO, and radiographic abnormalities were common. Long term follow up is required to determine the natural history post severe-COVID-19 lung disease. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/39918 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:31:26.417Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2024 |
| publishDateRange | 2024 |
| publishDateSort | 2024 |
| publisher | Department of Medicine |
| publisherStr | Department of Medicine |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/39918 Early sequelae of post COVID-19 lung disease in patients who were mechanically ventilated for severe COVID-19 pneumonia Singh, Nevadna Van Zyl-Smit, Richard Pulmonology Introduction: COVID-19 resulted in an unprecedented worldwide spike in hospital and ICU admissions; predominantly for adult respiratory distress syndrome (ARDS). Survival rates for patients requiring mechanical ventilation in Cape Town during the waves driven by the ancestral strain and beta variant were approximately 30% during the first 3 waves of the pandemic. However, post-ICU admission sequelae and recovery trajectory in sub-Saharan Africa remain unknown. Methods: We systematically evaluated a cohort of COVID-19 ICU survivors at three months following hospital discharge. A retrospective single-centre study enrolled all COVID-19 pneumonia patients who were admitted to ICU for mechanical ventilation and followed up at the post-COVID-19 Lung Disease Clinic between 1 July 2020 and 30 December 2021. Results: A total of 26 patients were evaluated at 3 months after discharge from hospital following mechanical ventilation: 53% were male and 81% had at least one co-morbidity. Diabetes and hypertension were present in 42% and 54% of patients respectively. Persistent dyspnoea (89%) and fatigue (54%) were the most common post-COVID-19 symptoms. Median FEV1 and FVC were 73% (IQR 65-83) and 71% (IQR 61-77) of predicted values respectively, whilst median DLCO was 59% (IQR 41- 70) of predicted values. Abnormalities were confirmed in all patients (24/26) who underwent high resolution computer tomography (HRCT) of the chest, with ground glass opacities (46%) and interstitial thickening (58%) being most common. No significant risk factors for post-COVID-19 impairment were identified. Conclusion: At 3 months after hospitalization, patients who received mechanical ventilation for COVID-19 pneumonia frequently reported ongoing symptoms. Lung function was moderately impaired with a disproportionate reduction in DLCO, and radiographic abnormalities were common. Long term follow up is required to determine the natural history post severe-COVID-19 lung disease. 2024-06-19T07:33:29Z 2024-06-19T07:33:29Z 2023 2024-06-06T13:53:50Z Thesis / Dissertation Masters MPhil http://hdl.handle.net/11427/39918 eng application/pdf Department of Medicine Faculty of Health Sciences |
| spellingShingle | Pulmonology Singh, Nevadna Early sequelae of post COVID-19 lung disease in patients who were mechanically ventilated for severe COVID-19 pneumonia |
| thesis_degree_str | Master's |
| title | Early sequelae of post COVID-19 lung disease in patients who were mechanically ventilated for severe COVID-19 pneumonia |
| title_full | Early sequelae of post COVID-19 lung disease in patients who were mechanically ventilated for severe COVID-19 pneumonia |
| title_fullStr | Early sequelae of post COVID-19 lung disease in patients who were mechanically ventilated for severe COVID-19 pneumonia |
| title_full_unstemmed | Early sequelae of post COVID-19 lung disease in patients who were mechanically ventilated for severe COVID-19 pneumonia |
| title_short | Early sequelae of post COVID-19 lung disease in patients who were mechanically ventilated for severe COVID-19 pneumonia |
| title_sort | early sequelae of post covid 19 lung disease in patients who were mechanically ventilated for severe covid 19 pneumonia |
| topic | Pulmonology |
| url | http://hdl.handle.net/11427/39918 |
| work_keys_str_mv | AT singhnevadna earlysequelaeofpostcovid19lungdiseaseinpatientswhoweremechanicallyventilatedforseverecovid19pneumonia |