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LETTER TO THE EDITOR
Year : 2021  |  Volume : 3  |  Issue : 1  |  Page : 4

100-day Lung Function Follow-up of a Critical COVID-19 Patient Treated with Mechanical Ventilation and Extracorporeal Membrane Oxygenation


1 Department of Critical Care Medicine, the First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
2 Department of Critical Care Medicine, The Sixth People' s Hospital of Shenyang, Shenyang, Liaoning Province, China

Date of Submission02-Feb-2021
Date of Acceptance06-Jun-2021
Date of Web Publication23-Aug-2021

Correspondence Address:
Dr. Zhidan Zhang
Department of Critical Care Medicine, the First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province
China
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DOI: 10.4103/jtccm.jtccm_10_21

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How to cite this article:
Li X, Zhang F, Wu Y, Zhang Z. 100-day Lung Function Follow-up of a Critical COVID-19 Patient Treated with Mechanical Ventilation and Extracorporeal Membrane Oxygenation. J Transl Crit Care Med 2021;3:4

How to cite this URL:
Li X, Zhang F, Wu Y, Zhang Z. 100-day Lung Function Follow-up of a Critical COVID-19 Patient Treated with Mechanical Ventilation and Extracorporeal Membrane Oxygenation. J Transl Crit Care Med [serial online] 2021 [cited 2021 Nov 30];3:4. Available from: http://www.tccmjournal.com/text.asp?2021/3/1/4/324282



Dear Editor,

A 42-year-old male patient was admitted to intensive critical unit for critical COVID-19 pneumonia. According to the diagnosis and treatment program of novel coronavirus pneumonia (Trial Fifth Edition) issued by the National Health Commission, he was diagnosed as critically ill. He presented with typical ground-glass opacities (GGOs) on admission [Figure 1]A1, [Figure 1]A2, red boxes]. Follow-up computed tomography (CT) images demonstrated progressions of multiple GGOs and GGO with interlobular septal thickening [[Figure 1] Jan 30 B1-B2, red arrow] and fibrous strips [[Figure 1] Feb 27 A3, B3, blue arrow]. Lung cavitation, discrete pulmonary nodules, pleural effusions, and lymphadenopathy were absent among the CT findings. The 100-day CT follow-up showed that the early consolidation was almost completely absorbed [Figure 1]C2, and only local interlobular septal thickening [[Figure 1]C1, blue arrow] was observed.
Figure 1: The patient presented with typical ground glass opacities on admission (A1-A2, red boxes). Follow-up computed tomography images demonstrated progressions of multiple ground-glass opacities and ground-glass opacities with interlobular septal thickening (B1-B2, red arrow) a month after hospitalization. C1-C3 showed that the early consolidation was almost completely absorbed.

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Pulmonary function test showed that forced expiratory volume (FEV1) was 2.79L, and the ratio of forced expiratory volume to forced vital capacity in one second (FEV1.0/FVC%) was 118%. The patient recovered well and was competent for daily activities, without cough, chest tightness, or dyspnea. His 6-min walking distance was 400 m.

Hamilton depression rating scale,[1] Patient Health Questionnaire-9 (PHQ-9),[2] Generalized Anxiety Disorder-7,[3] and Medical Outcomes Survey Short Form-36 (SF-36)[4] were used to evaluate his psychological distress level. The results showed that he had mild level of depression. With respect to his SF-36 results, the scores on social function, emotional function, and mental health decreased significantly. However, there was limited evidence for neurological and psychological influence by SARS-CoV-2.

This case revealed that, although a critical COVID-19 patient had severe diffuse lung damage, 100-day follow-up CT images showed an almost completely consolidation absorption with normal activity tolerance recovery. In addition, the long-term prognosis was satisfactory. The mental and psychological status of the patient was a crucial factor concerning the long-term prognosis, which needs early intervention.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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Leucht S, Fennema H, Engel R, Kaspers-Janssen M, Lepping P, Szegedi A. What does the HAMD mean? J Affect Disord 2013;148:243-8.  Back to cited text no. 1
    
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Hartung TJ, Friedrich M, Johansen C, Wittchen HU, Faller H, Koch U, et al. The Hospital Anxiety and Depression Scale (HADS) and the 9-item Patient Health Questionnaire (PHQ-9) as screening instruments for depression in patients with cancer. Cancer 2017;123:4236-43.  Back to cited text no. 2
    
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Patel JS, Youngha Oh, Rand KL, Wu W, Cyders MA, Kroenke K, et al. Measurement invariance of the patient health questionnaire-9 (PHQ-9) depression screener in U.S. adults across sex, race/ethnicity, and education level: NHANES 2005-2016. Depress Anxiety 2019;36:813-23.   Back to cited text no. 3
    
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Ogura K, Yakoub MA, Christ AB, Fujiwara T, Nikolic Z, Boland PJ, et al. What Are the Minimum Clinically Important Differences in SF-36 Scores in Patients with Orthopaedic Oncologic Conditions?Clin Orthop Relat Res 2020;478:2148-58.  Back to cited text no. 4
    


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