ABSTRACT
Aim of this study is to evaluate the incidence of fungal infections in COVID-19 intensive care unit (ICU) patients, to identify potential risk factors and to investigate whether differences in patients' outcomes are depicted. Material-Methods: This prospective observational study included critically ill patients diagnosed with COVID-19 that were admitted from 1/9/2020 to 1/11/2021 in ICU of the 1st Respiratory Department of Sotiria Chest Diseases Hospital. Epidemiologic characteristics, severity of disease, medication, outcome and complications were recorded. Result(s): Out of 300 patients included (213 men, 60,4+/-13,23 (mean+/-SD) years-old), 22 (7,3%) developed fungal infections (16 COVID-19 Associated Pulmonary Aspergillosis, 5 COVID-19 Associated Candidemia and 1 both). They were 6 female & 16 male, 55,73+/-13,28 years-old. Most patients had co-infections with multi-drug resistant bacteria. Patients with fungal infections were statistifically more on high dose of corticosteroids, invasive mechanical ventilation and renal replacement treatment (p<0.05). They had statistically more positive blood and bronchial secretion cultures, as well as more incidents of septic shock, venous thromboembolism and varotrauma (p<0.05). Their PaO2/FiO2 ratio on admission was statistically lower (p<0.05). Finally, after adjustment for confounfing factors and ICU days, they were at higher risk of dying (50% mortality). Conclusion(s): Fungal infections are a significant co-infection in critically ill COVID-19 patients. Those patients seem to have more severe respiratory failure on admission, be on higher doses of corticosteroids and in need of organ failure support. They also seem to develop more complications of COVID-19 and be at a higher risk of dying.
ABSTRACT
Background: COVID-19 ICU patients present respiratory and peripheral muscle weakness both during hospitalisation and following discharge. However, few studies have evaluated muscle strength in non-ICU hospitalised patients. Aim(s): To report the incidence of muscle weakness in non-ICU hospitalised patients and investigate the effect of pulmonary rehabilitation (PR) on respiratory and peripheral muscle strength. Method(s): Maximum static inspiratory (MIP) and expiratory (MEP) muscle pressures, quadriceps muscle force (QF), and handgrip strength were assessed in 21 patients (age: 56+/-12 yrs.) previously hospitalised with COVID-19, 94+/-32 days following discharge. Fifteen out of 21 patients were re-assessed three months later (10 following a PR program and 5 who declined PR and recovered at home (UC)). Result(s): 12/21 patients (57%) had reduced MIP and 18/21 patients (86%) reduced MEP (both <80% pred) (Wilson et al., Thorax 1984;39:535-538). Eleven patients (52%) had reduced QF and handgrip strength (both <80% pred). Data from the 3-month follow up period are presented in table 1. Conclusion(s): A number of patients hospitalised with COVID-19 presented with respiratory and peripheral muscle weakness 3 months following discharge. PR programme improved respiratory and peripheral muscle strength in these patients.
ABSTRACT
Background: Patients suffering from long COVID-19 syndrome have reduced emotional status) and impaired functional capacity;the effect of pulmonary rehabilitation (PR) on emotional status and functional capacity remain inconclusive. Aim(s): To investigate the effect of a hybrid PR program on QoL, emotional status and functional capacity in patients with long COVID-19 syndrome. Method(s): 15 patients (age (mean+/-SD): 55+/-14 yrs.) with excessive fatigue due to COVID-19 syndrome (FACIT score (25+/-11) were allocated to PR (n=10) or usual care (UC) (n=5), 85+/-29 days following hospital discharge. PR consisted of 8 outpatient PR sessions (twice weekly for 4 weeks), and 24 home-based PR sessions (3 times/week for 8 weeks). Patients in the UC declined PR and instructed to be physically active. Psychological status was assessed via HADS and Impact Event Scale-Revised (IES-R). Functional capacity was assessed via SPPB, 6MWD, and steps/day. Result(s): Data are presented in table 1. Conclusion(s): PR improves QoL and functional capacity in patients with long COVID-19 syndrome. (Table Presented).
ABSTRACT
Background: Exercise tolerance is limited in patients suffering from long COVID-19 syndrome several months after the acute phase of the disease. The effect of pulmonary rehabilitation (PR) on exercise tolerance is inconclusive. Aim(s): To investigate the effect of a hybrid PR program, combining outpatient and home-based PR, on exercise capacity in long COVID-19 syndrome. Method(s): 15 patients (age (mean+/-SD): 55+/-14 yrs.) with excessive fatigue due to long COVID-19 syndrome (FACIT score (25+/-11) were allocated to PR (n=10) or usual care (UC) (n=5) groups 85+/-29 days from hospital discharge. PR consisted of 8 outpatient PR sessions (twice weekly for 4 weeks), and 24 home-based PR sessions (3 times/week for 8 weeks). Patients in the UC were instructed to be physically active. Exercise tolerance was assessed during a cardiopulmonary exercise test to the limit of tolerance (Tlim). Result(s): Results are presented in table 1. Conclusion(s): A hybrid programme of PR improves exercise tolerance in patients with long COVID-19 syndrome.