COVID ICU Patients May Face Reduced Exercise Capacity, Impaired Lung Function

TOPLINE

Patients hospitalized with COVID pneumonia who required ICU admission demonstrated significantly reduced exercise capacity and more frequent restrictive pulmonary function patterns at 2 months postdischarge. Levels of inflammatory markers — including C-reactive protein (CRP), ferritin, and D-dimer — were elevated in the ICU group.

METHODOLOGY

• A retrospective cohort study analyzed 101 adult patients (mean age, 51.65 years) who were hospitalized with COVID in Türkiye between March 2020 and March 2022 and had completed at least 2 months after discharge.
• Patients were categorized by clinical severity: mild/moderate (clinical signs of pneumonia with SpO2 ≥ 90%) or severe/critical (SpO2 < 90%, respiratory rate > 30 breaths/min, or critical complications including acute respiratory distress syndrome or sepsis).
• Outcome measures included Six-Minute Walk Test (6MWT) distance, pulmonary function tests (PFT) including forced expiratory volume in the first second (FEV₁) and forced vital capacity (FVC), chest CT findings classified by COVID-19 Reporting and Data System (CO-RADS) categories, and laboratory parameters measured within 24 hours of admission.

TAKEAWAY

• Restrictive pulmonary patterns were observed in 32.7% of patients with severe/critical disease compared to 10.9% of those with moderate disease (P = .018), with significantly lower mean FEV₁ values and mean FVC values in patients with severe/critical vs moderate severity.
• Patients who required ICU admission had significantly lower exercise capacity (assessed by the 6MWT) and more frequent restrictive PFT results than patients who did not require ICU admission.
• Median ferritin levels, CRP levels, and D-dimer levels were significantly higher in the severe/critical group than the moderate group. Also, the levels of ferritin, CRP, and D-dimer were higher in the patients in the ICU group vs non-ICU group.
• Significant positive correlations were found between CRP and ferritin levels, between FEV₁ and FVC values, and between FVC and 6MWT distance.

IN PRACTICE

"[The study] findings emphasize the critical role of ICU admission in predicting early post-COVID pulmonary and functional impairment," the authors of the study wrote.

SOURCE

The study was led by Sevil Okan, Tokat Gaziosmanpasa University in Tokat, Türkiye. It was published online on July 24 in BMC Pulmonary Medicine.

LIMITATIONS

Baseline CT findings and exercise capacity data prior to SARS-CoV-2 infection were unavailable. Follow-up laboratory tests and repeat chest CT imaging were not performed to avoid unnecessary invasive procedures and radiation exposure. The single-center design and a small sample size, particularly in certain subgroups, limit generalizability.

DISCLOSURES 

The study did not receive any funding. The authors reported no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

A version of this article first appeared on Medscape.com.