d0df83681a732f2fd47c14974206b800 pmc_35011967.pdf 2661edb41e25c104fedcd000e3798631d192e55e pmc_35011967.pdf 92b99a61f22fa02e362a1d75e834e2887a3522b21835a0d1dd24f2fda0221f7f pmc_35011967.pdf Title: ICU-Acquired Pneumonia Is Associated with Poor Health Post-COVID-19 Syndrome Subject: 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. Keywords: COVID-19; CT abnormalities; ICU; lung function; SARS-CoV-2; sequelae; post-COVID Author: Ignacio Martin-Loeches, Anna Motos, Rosario Menéndez, Albert Gabarrús, Jessica González, Laia Fernández-Barat, Adrián Ceccato, Raquel Pérez-Arnal, Dario García-Gasulla, Ricard Ferrer, Jordi Riera, José Ángel Lorente, Óscar Peñuelas, Jesús F. Bermejo-Martin, David de Gonzalo-Calvo, Alejandro Rodríguez, Ferran Barbé, Luciano Aguilera, Rosario Amaya-Villar, Carme Barberà, José Barberán, Aaron Blandino Ortiz, Elena Bustamante-Munguira, Jesús Caballero, Cristina Carbajales, Nieves Carbonell, Mercedes Catalán-González, Cristóbal Galbán, Víctor D. Gumucio-Sanguino, Maria del Carmen de la Torre, Emili Díaz, Elena Gallego, José Luis García Garmendia, José Garnacho-Montero, José M. Gómez, Ruth Noemí Jorge García, Ana Loza-Vázquez, Judith Marín-Corral, Amalia Martínez de la Gándara, Ignacio Martínez Varela, Juan Lopez Messa, Guillermo M. Albaiceta, Mariana Andrea Novo, Yhivian Peñasco, Pilar Ricart, Luis Urrelo-Cerrón, Angel Sánchez-Miralles, Susana Sancho Chinesta, Lorenzo Socias, Jordi Solé-Violan, Luis Tamayo Lomas, Pablo Vidal and Antoni Torres Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Fri Dec 31 13:57:47 2021 CET ModDate: Fri Dec 31 14:01:44 2021 CET Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 15 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 500146 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- SWROGH+VnURWPalladioL Type 1 Custom yes yes no 10 0 VHXSAT+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 KIVFTL+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 DTXBWV+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 HYOSND+VnURWPalladioL-Bold Type 1 Custom yes yes no 28 0 MCBCCI+SourceSansRoman-Regular Type 1C Custom yes yes no 36 0 MCBCCM+SourceSansRoman.613wght Type 1C Custom yes yes no 40 0 MCBCCO+SourceSansRoman-Bold Type 1C Custom yes yes no 44 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 56 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 59 0 RWBCRL+CMSY10 Type 1 Builtin yes yes no 87 0 JLZORU+EURM10 Type 1 Builtin yes yes no 94 0 LHHGJJ+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 103 0 LHHGJK+PalatinoLinotype CID TrueType Identity-H yes yes yes 106 0 LHHGJL+PalatinoLinotype TrueType WinAnsi yes yes no 112 0 LHHGJN+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 115 0 QLBIEB+URWPalladioL-BoldItal Type 1 Custom yes yes no 122 0 MPUDFL+PazoMath Type 1 Builtin yes yes no 132 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2023-05-27 02:51:36 CEST RepresentationInformation: pmc_35011967.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2023-03-31 12:08:16 CEST Size: 500146 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 309 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@44c8afef Item: Title: Material and Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7b69c6ba Children: Item: Title: Study Design and Population Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@46daef40 Item: Title: Data Collection Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@12f41634 Item: Title: Procedures Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@13c27452 Item: Title: Outcomes Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Item: Title: Statistical Analysis Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@371a67ec Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@5ed828d Children: Item: Title: Definition of the Population Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@50d0686 Item: Title: Clinical Features and Associations with Functional (Lung Function Tests), Imaging and Laboratory Results at 3-Month Follow-Up Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7a3d45bd Item: Title: Factors Associated with Persistent Post-COVID-19 Symptoms Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1e7c7811 Item: Title: Discussion Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77ec78b9 Item: Title: Conclusions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1a3869f4 Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@a38d7a3 Info: Title: ICU-Acquired Pneumonia Is Associated with Poor Health Post-COVID-19 Syndrome Author: Ignacio Martin-Loeches, Anna Motos, Rosario Menéndez, Albert Gabarrús, Jessica González, Laia Fernández-Barat, Adrián Ceccato, Raquel Pérez-Arnal, Dario García-Gasulla, Ricard Ferrer, Jordi Riera, José Ángel Lorente, Óscar Peñuelas, Jesús F. Bermejo-Martin, David de Gonzalo-Calvo, Alejandro Rodríguez, Ferran Barbé, Luciano Aguilera, Rosario Amaya-Villar, Carme Barberà, José Barberán, Aaron Blandino Ortiz, Elena Bustamante-Munguira, Jesús Caballero, Cristina Carbajales, Nieves Carbonell, Mercedes Catalán-González, Cristóbal Galbán, Víctor D. Gumucio-Sanguino, Maria del Carmen de la Torre, Emili Díaz, Elena Gallego, José Luis García Garmendia, José Garnacho-Montero, José M. Gómez, Ruth Noemí Jorge García, Ana Loza-Vázquez, Judith Marín-Corral, Amalia Martínez de la Gándara, Ignacio Martínez Varela, Juan Lopez Messa, Guillermo M. Albaiceta, Mariana Andrea Novo, Yhivian Peñasco, Pilar Ricart, Luis Urrelo-Cerrón, Angel Sánchez-Miralles, Susana Sancho Chinesta, Lorenzo Socias, Jordi Solé-Violan, Luis Tamayo Lomas, Pablo Vidal and Antoni Torres Subject: 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. 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