RESUMEN
Background: Knowledge regarding the long-term impact of invasive mechanical ventilation on the inspiratory muscles and functional outcomes in COVID-19 survivors is limited. Methods: In this single-centre prospective cohort study, we evaluated invasively ventilated patients with COVID-19 pneumonia 3 and 6â months post-intensive care unit (ICU) discharge. Outcomes included: maximal inspiratory pressure (MIP), ultrasound parameters for diaphragm function, 6-min walk distance (6MWD), dyspnoea and quality of life. We evaluated associations between MIP and duration of mechanical ventilation with follow-up outcomes. Results: 50 COVID-19 survivors discharged from ICU between 15 October 2020 and 1 April 2021 were enrolled. Overall, survivors showed a recovery trajectory over time. However, impaired MIP remained in 24 (48%) and 12 (24%) at 3 and 6â months, respectively. Diaphragm dysfunction was not observed. At 3â months, 23 (46%) had impaired functional capacity versus 10 (20%) at 6â months. Dyspnoea persisted in 44 (88%) patients at 3â months and 38 (76%) at 6â months. Quality of life was slightly decreased at 3â months with further improvements at 6â months. MIP was correlated to 6MWD, 6MWD % predicted, dyspnoea across follow-up, and quality of life at 3â months. The duration of invasive ventilation was correlated with 6MWD and 6MWD % predicted. Conclusion: In invasively ventilated COVID-19 survivors, inspiratory muscle strength impairments persisted 6â months after ICU discharge, while maintaining normal diaphragm function. Decreased functional capacity, dyspnoea and slightly reduced health status were observed. Early screening of survivors is of utmost importance to identify those with impairments and at risk of delayed or incomplete recovery.