[Evidence summary:] What are the physical sequelae for critically ill COVID-19 patients?
| dc.contributor.author | National Health Library & Knowledge Service (NHLKS) | |
| dc.contributor.author | Delaunois, Isabelle | |
| dc.contributor.author | McKeown, Declan | |
| dc.contributor.author | Leen, Brendan | |
| dc.date.accessioned | 2020-07-22T11:19:33Z | |
| dc.date.available | 2020-07-22T11:19:33Z | |
| dc.date.issued | 2020-07-20 | |
| dc.identifier.uri | http://hdl.handle.net/10147/627881 | |
| dc.description | The European Centre for Disease Control and Prevention1 list respiratory and cardiovascular complications as possible sequelae of COVID-19 but the literature in general agrees that long-term sequelae of COVID-19 are still unknown. A search of the literature found a systematic review as well as cross-sectional and prospective studies on SARS and MERS survivors that could potentially inform the question about long-term sequelae of COVID-19. Ahmed et al3 conducted a systematic review and meta-analysis on the clinical outcomes of survivors of SARS and MERS outbreaks; the authors conclude that lung function abnormalities, psychological impairment and reduced exercise capacity were common in SARS and MERS survivors. Based on their findings, the authors advocate that clinicians anticipate and investigate similar long-term outcomes in COVID-19 survivors. Ong et al12 conclude that one year after recovery from SARS, persistent pulmonary function impairment was found in about one third of patients. The health status of SARS survivors was also significantly worse compared with the healthy population. Hui et al10 also conducted a 1 year cross-sectional survey of SARS survivors and came to the conclusion that significant impairment in DLCO [diffusing capacity of the lung for carbon monoxide] was noted in 23.7% of survivors 1 year after illness onset. Exercise capacity and health status of SARS survivors were remarkably lower than those of a normal population. Battawi et al4 looked at MERS survivors who required hospitalization in Saudi Arabia during 2016-2017, approximately 1 year after diagnosis. They compared characteristics of MERS survivors against those of survivors of non-MERS Severe Acute Respiratory Infection (SARI). The results show that functional scores were similar for MERS and non-MERS SARI survivors. However, MERS survivors of critical illness reported lower quality of life than survivors of less severe illness. According to Zhang et al18 the most severe sequelae after rehabilitation from SARS are femoral head necrosis and pulmonary fibrosis. The authors performed a 15-year follow-up on the lung and bone conditions of SARS patients. They evaluated the recovery from lung damage and femoral head necrosis in an observational cohort study of SARS patients using pulmonary CT scans, hip joint MRI examinations, pulmonary function tests and hip joint function questionnaires. They concluded that pulmonary interstitial damage and functional decline caused by SARS mostly recovered, with a greater extent of recovery within 2 years after rehabilitation. Femoral head necrosis induced by large doses of steroid pulse therapy in SARS patients was not progressive and was partially reversible. According to Candan et al6 research has focused in recent years on poor long-term functional outcomes in patients with Adult Respiratory Distress Syndrome (ARDS), often associated with ICU-acquired weakness, deconditioning, and myopathies and neuropathies. In addition to physical therapists providing respiratory support in the ICU, the literature unequivocally supports the view that early intervention for ICU management of patients with ARDS secondary to COVID-19 needs to focus on reducing contributors to impaired long-term function, with direct attention paid to preventing or managing ICU-acquired weakness, deconditioning, and myopathies and neuropathies, in conjunction with respiratory care. Salehi et al15 looked at long term pulmonary consequences of COVID-19. According to the authors, organizing pneumonia and diffuse alveolar damage seem to be, by far, the most common forms of lung injury associated with COVID-19, and both evolve in a fairly predictable manner. They suggest that long-term follow-up chest imaging of survivors is needed for a better understanding of the possible irreversible pulmonary damages of SARS-CoV-2 pneumonia. They advise follow-up evaluation of recovered patients by a respiratory physician. Several studies look at the neurological sequelae of COVID-19 2, 5, 11, 13, 16. Abboud et al2 discuss several neurological aspects reported in the literature to date, including the evidence and pathways of the neuro-invasion in COVID-19, and the main neurological disorders reported in the literature to date, as well as the future perspectives and the potential long-term consequence of current neuro-infection in COVID-19 patients. In their review of the literature, Ogier et al11 provide an overview of the current knowledge on neurologic sequelae of COVID-19 and their possible aetiology, and, based on available data, propose possible improvements in current medical care procedures. Papa et al13 look at Parkinson’s Disease and state that it is too early to know whether COVID‐19 will have long-term neurological complications. They observe that the facts that hyposmia is a common feature of early PD and that the olfactory system is an early predilection site for alpha-synuclein pathology might just be an intriguing coincidence but it is however notable that recent studies indicate that alpha-synuclein participates in the innate immune response to any viral infection. They believe that these observations could be important. According to De Felice et al8 emerging evidence suggests that SARS-CoV-2 is associated with neurological alterations in COVID-19 patients presenting with severe clinical manifestations. According to the authors, the impact of SARS-CoV-2 on the CNS could 1. lead to neurological alterations directly; 2. worsen pre-existing neurological conditions; and/or 3. increase susceptibility to or aggravate damage caused by other insults. Other studies look at oral health9, the development of a tool to ensure the full spectrum of functional outcomes following COVID-197, antimicrobial resistance14 and the cardiovascular system. | en_US |
| dc.language.iso | en | en_US |
| dc.publisher | Health Service Executive | en_US |
| dc.relation.ispartofseries | Evidence summaries | en_US |
| dc.subject | CORONAVIRUS | en_US |
| dc.subject | COVID-19 | en_US |
| dc.subject | LONG TERM EFFECTS | en_US |
| dc.subject | PHYSICAL EFFECTS | en_US |
| dc.title | [Evidence summary:] What are the physical sequelae for critically ill COVID-19 patients? | en_US |
| dc.title.alternative | v1.0 | en_US |
| dc.type | Other | en_US |
| refterms.dateFOA | 2020-07-22T11:19:35Z |
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HSE Library Summaries of Evidence
Evidence summaries and reviews on the management and treatment of Novel Coronavirus Covid-19 and other clinical topics