Mid-Term Sequelae of Surviving Patients Hospitalized in Intensive Care Unit for COVID-19 Infection: The REHCOVER Study

Marie Berger, Delphine Daubin, Jeremy Charriot, Kada Klouche, Vincent Le Moing, David Morquin, Laurence Halimi, Audrey Jaussent, Patrice Taourel, Maurice Hayot, Jean-Paul Cristol, Nicolas Nagot, Pierre Fesler, Camille Roubille, Marie Berger, Delphine Daubin, Jeremy Charriot, Kada Klouche, Vincent Le Moing, David Morquin, Laurence Halimi, Audrey Jaussent, Patrice Taourel, Maurice Hayot, Jean-Paul Cristol, Nicolas Nagot, Pierre Fesler, Camille Roubille

Abstract

Objectives: The objective of this prospective, single-center study was to explore the mid-term outcomes 6 to 9 months after hospitalization in an Intensive Care Unit (ICU) for severe COVID-19 infection.

Methods: Patients systematically underwent biological tests, pulmonary function tests, chest computed tomography (CT) scan, and psychological tests.

Results: Among 86 patients, including 71 (82.6%) men, median age of 65.8 years (56.7; 72.4), 57 (71.3%) patients presented post-COVID-19 asthenia, 39 (48.1%) muscle weakness, and 30 (36.6%) arthralgia. Fifty-two (64.2%) patients had a decreased diffusion capacity for carbon monoxide (DLCO) <80% and 16 (19.8%) had DLCO <60%. Chest CT-scans showed ground glass opacities in 35 (40.7%) patients, and reticular changes in 28 patients (33.7%), including fibrosis-like changes in 18 (21.7%) patients. Reticular changes and DLCO <60% were associated with length of stay in ICU, and reticular changes with higher maximal CRP level. The psychological questionnaires found 37.7% suffered from depression, 23.5% from anxiety, 42.4% from insomnia, and 9.4% from post-traumatic stress. Being female was associated with a higher frequency of depression and anxiety, with depression scores being associated with obesity.

Conclusions: Many patients hospitalized in ICU for severe COVID-19 infection have mid-term sequelae. Additional studies on the prognostic factors seem necessary.

Keywords: COVID-19; SARS-COV-2; intensive care; mid-term outcomes; sequelae.

Conflict of interest statement

M.B.: none; D.D.: none; J.C.: none; K.K.: none; V.L.M.: none; D.M.: none; L.H.: none; A.J.: none; P.T.: none; M.H.: none; J.-P.C.: none; N.N.: none; P.F.: has received travel and accommodation fees from Actelion, Johnson and Johnson, BMS, Pfizer, and Servier in the last 5 years, unrelated to this work. C.R.: reports personal fees from Servier and Pfizer in the last five years, unrelated to this work.

Figures

Figure 1
Figure 1
Study design. Abbreviations: ICU: intensive care unit; COVID-19: Coronavirus Disease-19.
Figure 2
Figure 2
Example of CT-scan evolution in a 76-year-old patient. (A,C) acute COVID-19 phase. (B,D) CT-scan performed 7 months later showing persistent ground glass opacities (B) and retractile reticulations (D).

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