Persistence of respiratory deficits in post-COVID-19 patients: 36 months after hospital discharge

Abstract

Introduction: COVID-19, caused by SARS-CoV-2, is an acute respiratory infection with high transmissibility and multiple complications, particularly pulmonary. Patients who required invasive mechanical ventilation (IMV) are at increased risk of long-term respiratory sequelae. Objective: To investigate the presence of respiratory deficits in post-COVID-19 individuals, 36 months after hospital discharge, who underwent IMV. Methods: A cross-sectional study conducted between December 2023 and May 2024 with patients discharged from the intensive care unit between November 2020 and August 2021. Sociodemographic data, Maximum Inspiratory Pressure (MIP), Maximum Expiratory Pressure (MEP), and dyspnea using the Medical Research Council (mMRC) scale were collected. Statistical analysis was performed using R soft-ware, with paired Student's t-tests and Fisher's exact test (p < 0.05). Results: Of the 149 eligible patients, 31 comprised the final sample. The mean age was 54.27 ± 14.59 years, and the mean body mass index was 32.52 ± 4.88 kg/m². A significant reduction in MIP was observed in the age groups 20–29 years (53% of predicted), 30–39 years (86%), and 50–59 years (72%). MEP was higher among older adults aged 70–79 years (119% of predicted). There was an association between inspiratory muscle weakness and the duration of neuromuscular blocker (NMB) use (p = 0.047), as well as a correlation between dyspnea and comorbidities (p = 0.04). Conclusion: The study identified a reduction in MIP among younger individuals, with an association between inspiratory muscle weakness and NMB duration, as well as between dyspnea and comorbidities. These findings highlight the importance of continuous respiratory rehabilitation and personalized clinical care.