One-year survival and Quality of Life of first wave COVID-19 invasively ventilated patients in Lombardy, Italy

BACKGROUND: Lombardy was the epicenter of the first coronavirus disease 2019 (COVID-19) outbreak in western countries. The outbreak began in February 2020 and rapidly disseminated throughout the region. ICU beds were vastly insufficient and clinical knowledge of disease was poor at that time. Unfortunately, data on long-term mortality, morbidity, and Quality of Life are scarce and controversial. The aim of this study was to evaluate 1-year survival, Quality of Life, and functional recovery in patients with COVID-19 admitted to Intensive Care Units. METHODS: All COVID-19 patients invasively ventilated and successfully discharged from 3 important academic hospitals in Lombardy were evaluated. Evaluations were performed by qualified medical staff and monitoring over time was performed by telephone call. Functional, cognitive, and psychological outcomes were explored using validated questionnaires. Selected patients were offered a follow-up chest computed tomography (CT) scan. RESULTS: Four hundred twenty-seven patients were invasively ventilated and 268 (63%) were successfully discharged. Out of these 268 patients, 266 (99%) were alive at one year with no patient loss during follow-up. Very severe or severe dyspnea was reported by 7% of patients, while most patients (84%) did not experience dyspnea at rest. A small proportion of patients (17%) reported severe anxiety/depression. Good Quality of Life was reported by 64% of survivors. In patients complaining of dyspnea on exertion, fibrotic-like changes were observed at chest CT scans in 32/37 (86%) and 7/11 (63%) patients who underwent CT at 3 months and 1 year, respectively. CONCLUSIONS: COVID-19 patients discharged from the hospital after invasive ventilation had excellent one-year survival and good overall recovery and Quality of Life.