Ashton Engdahl, MD
Anesthesiology Resident
Virginia Commonwealth University Medical Center, United States
Disclosure information not submitted.
Yuchi Ma, BS
Medical Student
Virginia Commonwealth University Medical Center, United States
Disclosure information not submitted.
Nancy Woods, MBA, RRT
Director of Respiratory, Radiology, and Laboratory
Vibra Hospital of Richmond, United States
Disclosure information not submitted.
Kenneth Potter, MD
Assistant Professor of Anesthesiology and Critical Care
Virginia Commonwealth University Health Center, United States
Disclosure information not submitted.
Title: Characteristics of COVID-19 Patients Admitted to A Long Term Acute Care Hospital (LTACH)
INTRODUCTION/HYPOTHESIS: The novel respiratory virus SARS-CoV-2 is a member of the coronavirus family and causative agent of COVID-19. The disease associated with COVID-19 is closely related to severe acute respiratory syndrome (SARS) and middle east respiratory syndrome (MERS), both of which are known to cause persistent disease for at least a year after initial infection. Of the COVID-19 cases requiring hospitalization, roughly 10-20% require mechanical ventilation. Often, these patients have a protracted course with need for prolonged vent weaning. Though existing COVID-19 research has focused on the acute clinical course, it has become clear COVID-19 has long term consequences and increasing numbers of patients are transitioning from the ICU to long term acute care hospitals (LTACHs). As a result, we aim to describe the clinical course of patients who presented to a LTACH after infection with COVID-19.
Methods: This retrospective cohort study was approved by the Virginia Commonwealth institutional review board, which waived the requirement for written informed consent. We collected data from patients >18 years of age with hypoxic respiratory failure secondary to COVID-19 infection admitted to a LTACH setting between January 2020 and April 2021. Exclusion criteria included patients under 18 years of age and vulnerable groups. Demographic data was gathered, and the presence of comorbidities was noted. Type of airway, date of tracheostomy, admission day, weaning data, weaning time, decannulation data, and time to decannulation were noted. Frequency of suctioning at days 1, 7, 14, and 21 was recorded.
Results: A total of 20 patients were included. The average wean time was 29.4±18.8 days from tracheostomy placement to liberation from the ventilator for 48hrs. Average age of the cohort was 58±17 with an average of 3 comorbidities and an average BMI of 33.9±9.4. Patients were 60% male and 35% white. On average suction frequency peaked on day 14 and decreased back to admission baseline on day 28. 75% of patients were successfully weaned and 25% of patients were successfully decannulated prior to discharge.
Conclusions: Understanding of the unique characteristics of COVID-19 patients is important for the expedient and successful ventilator weaning and survival of these patients.