TYPE: Abstract
TOPIC: Critical Care
PURPOSE: Dyspnea is a common yet non-specific complaint in survivors of critical illness from COVID-19 pneumonia. We investigate whether lung ultrasound score and diaphragm excursion correlate with patient-reported dyspnea in a post-ICU clinic.
METHODS: The cohort consisted of 37 adult patients who survived to hospital discharge from COVID-19 pneumonia (hypoxemic respiratory failure requiring high-flow nasal cannula, invasive or non-invasive ventilation). Subjects established care in a post-ICU clinic and underwent thoracic ultrasound to compute Lung Ultrasound Score and Diaphragm Excursion per predetermined protocols. Patient-reported dyspnea was measured per the Borg Dyspnea Scale (BDS) at rest and following 6-Minute Walk Test (6MWT).
RESULTS: The average lung ultrasound score was 8.4, average rated dyspnea per BDS was 0.7 at rest and 2.6 at end-exertion. During the 6MWT the average nadir room-air oxygen saturation (SaO2) was 88%. Using Pearson Correlation Coefficient (r), we found that higher lung ultrasound score correlated significantly with higher patient-reported dyspnea per BDS at rest (r=+0.37, p=0.023) and at end-exertion of 6MWT (r=+0.46, p<0.005) and correlated significantly with lower SaO2 levels during 6MWT (r=-0.61, p<0.001). Diaphragm excursion did not correlate significantly with dyspnea, 6MWT, or SaO2.
CONCLUSIONS: A higher lung ultrasound score is associated with more patient-reported dyspnea and lower oxygen saturation during exertion in survivors of critical illness from COVID-19 pneumonia.
CLINICAL IMPLICATIONS: Performing lung ultrasound may help identify etiologies of dyspnea in survivors from severe COVID-19 pneumonia, predict which patients will require oxygen therapy, and determine the degree of interstitial lung disease during the recovery phase following severe viral pneumonia in a post-ICU population.
DISCLOSURE: Funding & Grant Information: CHEST Foundation Research Grant in Ultrasonography and COVID-19.
KEYWORD: covid-19, acute respiratory failure, critical care outcomes, chest ultrasound, survivorship.