scholarly journals Reversible Bronchiectasis in COVID-19 Survivors With Acute Respiratory Distress Syndrome: Pseudobronchiectasis

2021 ◽  
Vol 8 ◽  
Author(s):  
Qiongjie Hu ◽  
Yiwen Liu ◽  
Chong Chen ◽  
Ziyan Sun ◽  
Yujin Wang ◽  
...  

To retrospectively analyze whether traction bronchiectasis was reversible in coronavirus disease 2019 (COVID-19) survivors with acute respiratory distress syndrome (ARDS), and whether computed tomography (CT) findings were associated with the reversibility, 41 COVID-19 survivors with ARDS were followed-up for more than 4 months. Demographics, clinical data, and all chest CT images were collected. The follow-up CT images were compared with the previous CT scans. There were 28 (68%) patients with traction bronchiectasis (Group I) and 13 (32%) patients without traction bronchiectasis (Group II) on CT images. Traction bronchiectasis disappeared completely in 21 of the 28 (75%) patients (Group IA), but did not completely disappear in seven of the 28 (25%) patients (Group IB). In the second week after onset, the evaluation score on CT images in Group I was significantly higher than that in Group II (p = 0.001). The proportion of reticulation on the last CT images in Group IB was found higher than that in Group IA (p < 0.05). COVID-19 survivors with ARDS might develop traction bronchiectasis, which can be absorbed completely in most patients. Traction bronchiectasis in a few patients did not disappear completely, but bronchiectasis was significantly relieved. The long-term follow-up is necessary to further assess whether traction bronchiectasis represents irreversible fibrosis.

2021 ◽  
Vol 15 (8) ◽  
pp. 2522-2524
Author(s):  
Zahid Khan ◽  
Muhammad Habib Khan ◽  
Shah Hussain ◽  
Jehan Badshah ◽  
Riaz Uddin ◽  
...  

Objective: The aim of this study is to determine the efficacy and safety of corticosteroids for persistent acute respiratory distress syndrome. Study Design: Randomized Control Trial Place and Duration: The study was conducted at the emergency department of Lady Reading hospital Peshawar for the duration of six months during the period July to December 2020. Methods: Total 150 patients suffering from acute respiratory distress syndrome were presented in this study. Patients were aged between 40-75 years. Patients’ detailed demographics age, sex and body mass index were recorded after taking informed written consent. Patients were equally divided into-2 groups. Group I received corticosteroids and group II received placebo for 7-days of duration. At 28th day efficacy among both groups were assessed and compared in terms of low mortality, free from ventilator and reduction in complications. Complete data was analyzed by SPSS 24.0 version. Results: There were 120 males (60 in each group) and 30 (15 in each group) were females. Mean age of the patients in group I was 59.14±6.45 years with mean BMI 25.88±3.42 kg/m2 and in group II mean age was 58.38±7.46 years with mean BMI 26.41±3.54 kg/m2.Smoking was the most common cause of ARDS, in group I among 40 (53.3%) patients and 42 (56%), followed by chronic lung disease 20 (26.7%) in group I and 19 (25.3%) in group II. After regular follow up, mortality rate among patients of group II was greater 18 (24%) as compared to steroids group 13 (17.3%) and frequency of ventilator free patients were higher among steroids group 39 (52%) as compared to placebo 31 (41.3%). We found that complications reduction in steroids group was greater with minimum recurrence rate. Conclusion: We concluded in this study that the use of corticosteroids for persistent acute respiratory distress syndrome was effective and reliable in terms of low mortality and shorten the time of ventilation. Except this reduction in complications with minimum recurrence rate was found among patients those received steroids. Keywords: Acute respiratory distress syndrome, Placebo, Corticosteroids, Efficacy, Ventilator


Radiology ◽  
1999 ◽  
Vol 210 (1) ◽  
pp. 29-35 ◽  
Author(s):  
Sujal R. Desai ◽  
Athol U. Wells ◽  
Michael B. Rubens ◽  
Timothy W. Evans ◽  
David M. Hansell

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Kirby P. Mayer ◽  
Jamie L. Sturgill ◽  
Anna G. Kalema ◽  
Melissa K. Soper ◽  
Sherif M. Seif ◽  
...  

Abstract Background In this case report, we describe the trajectory of recovery of a young, healthy patient diagnosed with coronavirus disease 2019 who developed acute respiratory distress syndrome. The purpose of this case report is to highlight the potential role of intensive care unit recovery or follow-up clinics for patients surviving acute hospitalization for coronavirus disease 2019. Case presentation Our patient was a 27-year-old Caucasian woman with a past medical history of asthma transferred from a community hospital to our medical intensive care unit for acute hypoxic respiratory failure due to bilateral pneumonia requiring mechanical ventilation (ratio of arterial oxygen partial pressure to fraction of inspired oxygen, 180). On day 2 of her intensive care unit admission, reverse transcription–polymerase chain reaction confirmed coronavirus disease 2019. Her clinical status gradually improved, and she was extubated on intensive care unit day 5. She had a negative test result for coronavirus disease 2019 twice with repeated reverse transcription–polymerase chain reaction before being discharged to home after 10 days in the intensive care unit. Two weeks after intensive care unit discharge, the patient returned to our outpatient intensive care unit recovery clinic. At follow-up, the patient endorsed significant fatigue and exhaustion with difficulty walking, minor issues with sleep disruption, and periods of memory loss. She scored 10/12 on the short performance physical battery, indicating good physical function. She did not have signs of anxiety, depression, or post-traumatic stress disorder through self-report questionnaires. Clinically, she was considered at low risk of developing post–intensive care syndrome, but she required follow-up services to assist in navigating the healthcare system, addressing remaining symptoms, and promoting return to her pre–coronavirus disease 2019 societal role. Conclusion We present this case report to suggest that patients surviving coronavirus disease 2019 with subsequent development of acute respiratory distress syndrome will require more intense intensive care unit recovery follow-up. Patients with a higher degree of acute illness who also have pre-existing comorbidities and those of older age who survive mechanical ventilation for coronavirus disease 2019 will require substantial post–intensive care unit care to mitigate and treat post–intensive care syndrome, promote reintegration into the community, and improve quality of life.


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