Key Factors Associated With Pulmonary Sequelae in the Follow-Up of Critically Ill COVID-19 Patients

Introduction: Critical COVID-19 survivors have a high risk of respiratory sequelae. Therefore, we aimed to identify key factors associated with altered lung function and CT scan abnormalities at a follow-up visit in a cohort of critical COVID-19 survivors. Methods: Multicenter ambispective observational study in 52 Spanish intensive care units. Up to 1327 PCR-confirmed critical COVID-19 patients had sociodemographic, anthropometric, comorbidity and lifestyle characteristics collected at hospital admission; clinical and biological parameters throughout hospital stay; and, lung function and CT scan at a follow-up visit. Results: The median [p25–p75] time from discharge to follow-up was 3.57 [2.77–4.92] months. Median age was 60 [53–67] years, 27.8% women. The mean (SD) percentage of predicted diffusing lung capacity for carbon monoxide (DLCO) at follow-up was 72.02 (18.33)% predicted, with 66% of patients having DLCO < 80% and 24% having DLCO < 60%. CT scan showed persistent pulmonary infiltrates, fibrotic lesions, and emphysema in 33%, 25% and 6% of patients, respectively. Key variables associated with DLCO < 60% were chronic lung disease (CLD) (OR: 1.86 (1.18–2.92)), duration of invasive mechanical ventilation (IMV) (OR: 1.56 (1.37–1.77)), age (OR [per-1-SD] (95%CI): 1.39 (1.18–1.63)), urea (OR: 1.16 (0.97–1.39)) and estimated glomerular filtration rate at ICU admission (OR: 0.88 (0.73–1.06)). Bacterial pneumonia (1.62 (1.11–2.35)) and duration of ventilation (NIMV (1.23 (1.06–1.42), IMV (1.21 (1.01–1.45)) and prone positioning (1.17 (0.98–1.39)) were associated with fibrotic lesions. Conclusion: Age and CLD, reflecting patients’ baseline vulnerability, and markers of COVID-19 severity, such as duration of IMV and renal failure, were key factors associated with impaired DLCO and CT abnormalities

Clinical Validation of a Virtual Environment Test for Safe Street Crossing in the Assessment of Acquired Brain Injury Patients with and without Neglect

Part 1: Long and Short PapersInternational audienceAcquired brain injury (ABI) is a complex disease that involves loss of brain functions related to cognitive and motor capabilities and that can produce unilateral spatial neglect (USN). The heterogeneity of the symptoms of these disorders causes a lack of consensus on suitable tools for evaluation and treatment. Recently, several studies have initiated the application of virtual reality (VR) systems as an evaluation instrument for neuropsychological disorders. Our main objective was to evaluate the validity of the VR Street Crossing Test (VRSCT) as an assessment tool. Twenty-five patients with ABI were evaluated with traditional tests and with the VRSCT. The results showed significant correlations between the conventional tests and the measures obtained with the VRSCT in non-negligent patients. Moreover, the VRSCT indicated significant differences in performance of negligent and non-negligent subjects. These pilot results indicate that ABI patients with and without USN can be assessed by the therapists using the VRSCT system as a complementary tool