The following is a summary of “Fibrotic-Like Pulmonary Radiographic Patterns Are Not Associated With Adverse Outcomes in COVID-19 Chronic Critical Illness,” published in the June 2023 issue of Critical Care by Madahar et al.

Researchers started a retrospective study to characterize the risks and outcomes of fibrotic-like radiographic abnormalities in COVID-19-related acute respiratory distress syndrome (ARDS) and chronic critical illness.

They conducted a single-center study, examining chest CT scans performed between ICU discharge and 30 days after hospital discharge using established methods to quantify non-fibrotic and fibrotic-like patterns. This included adults hospitalized with COVID-19-related ARDS and chronic critical illness, meeting the criteria of more than 21 days of mechanical ventilation, tracheostomy, and survival to ICU discharge between March 2020 and May 2020.

The results showed 616 adults with COVID-19-related ARDS, 23% developed chronic critical illness, and 46% had a chest CT a median of 66 days after intubation. Fibrotic-like patterns, characterized by reticulations and/or traction bronchiectasis, were observed in 55% of cases. In adjusted analyses, interleukin-6 level on the day of intubation was associated with fibrotic-like patterns (odds ratio, 4.40 per quartile change; 95% CI, 1.90–10.1 per quartile change). Other inflammatory biomarkers, Sequential Organ Failure Assessment score, age, tidal volume, driving pressure, and ventilator days did not show associations. Fibrotic-like patterns did not delay ventilator liberation or worsen 6-month survival.

They concluded that half of COVID-19 chronic critical illness patients have fibrotic-like patterns linked to higher interleukin-6 levels but not worse outcomes.

Source: journals.lww.com/ccmjournal/abstract/9900/fibrotic_like_pulmonary_radiographic_patterns_are.166.aspx