RESPIRATORY PARAMETERS, PULMONARY REHABILITATION and SURVIVAL in COVID-19 PATIENTS
Background: Coronavirus disease 2019 (COVID-19) is a highly infectious viral illness, which targets patient’s respiratory system. Objectives: To (1) determine whether respiratory mechanics, oxygenation impairment, sociodemographics, and multimorbidity of mechanically ventilated COVID-19 subjects are associated with survival; (2) determine the factors associated with physical function status after completing six weeks of pulmonary rehabilitation (PR) of COVID-19 subjects with persisting pulmonary symptoms; and (3) investigate the impact of socioeconomic (SES) disparities on participation in PR and morbidity of Long COVID patients. Design: Retrospective analysis using the electronic health records. Participants: Adults ≥ 18 years, with positive COVID-19 diagnosis that were mechanically ventilated (n = 415). Adults with positive COVID-19 diagnosis with persisting dyspnea that completed PR (n = 68). Adults with ICD-10 diagnosis for Long COVID within the TriNetX database (n = 67,019). Measures: Sociodemographics, comorbid conditions, respiratory mechanics, University of California – San Diego Shortness of Breath Questionnaire score, 6-minute walking distance, anxiety, depression, post-traumatic stress disorder, survival and morbidity. Analysis: Descriptive statistics were performed to assess the sample characteristics. Generalized estimating equation models was used to assess survival. Multivariate regression was used to assess improvement in physical function. Kaplan curve analysis was performed to assess participation of PR and morbidity. Results: Being younger, female, and Non-Hispanic White were associated with survival of mechanically ventilated COVID-19 patients. Most Long COVID patients had improved physical function following PR. Conclusions: Sociodemographic factors were significantly associated with survival. As pulmonary dynamic compliance increased, survival increased in mechanically ventilated COVID-19 subjects. Non-Hispanic Blacks had lower odds of physical function improvement after completing PR than Non-Hispanic Whites. Long COVID patients with SES disparities were more likely to have lasting morbidity issues.
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The University of Texas Medical Branch at Galveston