HealthDay News — A majority of survivors of severe COVID-19 recover command-following weeks after cessation of mechanical ventilation, according to a study published online March 7 in the Annals of Neurology.
Greer Waldrop, M.D., from the Columbia University Irving Medical Center in New York City, and colleagues conducted a retrospective cohort study during March to July 2020 to estimate the time from intubation to recovery of command-following. A total of 795 patients were included who were admitted with severe COVID-19, had endotracheal intubation for at least seven days, and had impairment of consciousness.
The researchers found that 571 of the patients recovered command-following, with a median of 30 days to recovery of command-following. Patients with at least one episode of an arterial partial pressure of oxygen (PaO2) value ≤55 mm Hg had a 16-day increase in the median time to recovery of command-following; 25 percent recovered 10 or more days after mechanical ventilation cessation. There was an association seen for time to recovery of consciousness with hypoxemia (hazard ratios, 0.56 and 0.88 for PaO2 ≤55 mm Hg and ≤70 mm Hg, respectively); after accounting for confounders, including sedation, each additional day of hypoxemia reduced the likelihood of recovery. These findings were confirmed among 199 patients without imaging evidence of structural brain injury and in a nonoverlapping cohort of 427 patients during the second surge (October to April 2021).
“Our findings invite further consideration of the direct effects of hypoxemia on neuronal function that may account for prolonged time to recovery of consciousness,” the authors write.
One author disclosed financial ties to Bristol Myers Squibb relating to a study on a therapy for severe COVID-19.