Recovery from COVID-19 and acute respiratory distress syndrome: the potential role of an intensive care unit recovery clinic: a case report
Recovery from COVID-19 and acute respiratory distress syndrome: the potential role of an intensive care unit recovery clinic: a case report
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DOI：
10.1186/s13256-020-02481-y
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发表时间：
2020-09-10
影响因子：
1
通讯作者：
Morris, Peter E.
中科院分区：
文献类型：
--
作者：
Mayer, Kirby P.;Sturgill, Jamie L.;Morris, Peter E.
背景在本病例报告中，我们描述了一名年轻、健康的2019年冠状病毒病患者发展为急性呼吸窘迫综合征的康复轨迹。本病例报告的目的是强调重症监护病房康复或后续诊所对2019年因冠状病毒病急性住院幸存患者的潜在作用。病例介绍我们的患者是一位27岁的高加索女性，既往有哮喘病史从社区医院转至我们的内科重症监护病房，因双侧肺炎需要机械通气(动脉血氧分压与吸入氧分数之比，180)导致急性缺氧性呼吸衰竭。在她入住重症监护病房的第二天，逆转录-聚合酶链式反应确认了2019年冠状病毒病。她的临床状况逐渐好转，在重症监护病房第5天拔管。她在重症监护病房10天后出院前，曾两次经反复逆转录-聚合酶链式反应检测出2019年冠状病毒病阴性结果。重症监护病房出院两周后，患者回到我们的门诊重症监护病房康复诊所。在随访中，患者出现了严重的疲惫和疲惫，行走困难，睡眠中断的小问题，以及记忆力丧失的时期。她在短时表现体能电池上得了10分12分，这表明她的身体机能良好。通过自我报告问卷，她没有焦虑、抑郁或创伤后应激障碍的迹象。临床上，她被认为患重症监护后综合征的风险很低，但她需要后续服务，以帮助导航医疗系统，解决剩余症状，并促进回到她在2019年冠状病毒病前的社会角色。结论我们提交这一病例报告是为了建议，在2019年冠状病毒病中幸存下来并随后发展为急性呼吸窘迫综合征的患者将需要更密集的重症监护病房恢复随访。2019年因冠状病毒病而在机械通气中幸存下来的急性疾病程度较高的患者以及既有并存疾病的老年患者将需要大量的重症监护病房护理，以缓解和治疗重症监护后综合症，促进重新融入社区，并提高生活质量。
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.