Long-Term Morbidity Associated With Non-COVID-19 Pneumonia in Patients Receiving Mechanical VentilationTake-Home Points
Background: The COVID-19 pandemic highlighted the impact of acute respiratory illnesses on long-term morbidity. However, the long-term morbidity associated with non-COVID-19 pneumonia is unclear, particularly in patients who are receiving mechanical ventilation. Research Question: What is the burden...
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| Language: | English |
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Elsevier
2025-09-01
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| Series: | CHEST Critical Care |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2949788425000346 |
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| author | Alexander T. Clark, MD Clark I. Strunk, MD Matthew W. Semler, MD, MSCI Jonathan D. Casey, MD, MSCI Cathy A. Jenkins, MS Guanchao Wang, MS James C. Jackson, PsyD E. Wesley Ely, MD, MPH Amy L. Kiehl, MA Patsy T. Bryant, MS Alana Lauck, MS Stephanie C. DeMasi, MD Robert E. Freundlich, MD, MSCI Wesley H. Self, MD, MPH Rameela Raman, PhD Jin H. Han, MD |
| author_facet | Alexander T. Clark, MD Clark I. Strunk, MD Matthew W. Semler, MD, MSCI Jonathan D. Casey, MD, MSCI Cathy A. Jenkins, MS Guanchao Wang, MS James C. Jackson, PsyD E. Wesley Ely, MD, MPH Amy L. Kiehl, MA Patsy T. Bryant, MS Alana Lauck, MS Stephanie C. DeMasi, MD Robert E. Freundlich, MD, MSCI Wesley H. Self, MD, MPH Rameela Raman, PhD Jin H. Han, MD |
| author_sort | Alexander T. Clark, MD |
| collection | DOAJ |
| description | Background: The COVID-19 pandemic highlighted the impact of acute respiratory illnesses on long-term morbidity. However, the long-term morbidity associated with non-COVID-19 pneumonia is unclear, particularly in patients who are receiving mechanical ventilation. Research Question: What is the burden of 12-month long-term cognitive impairment (LTCI), functional impairment, psychological distress, and quality of life in critically ill patients receiving mechanical ventilation for non-COVID-19 pneumonia? Study Design and Methods: This single-site prospective cohort study enrolled patients with non-COVID-19 pneumonia receiving mechanical ventilation in the emergency department and ICUs from June 18, 2018, through August 30, 2021. Global cognition at 12 months was measured by the Montreal Cognitive Assessment for the Blind, with higher scores representing better cognition. Secondary outcomes were basic and instrumental activities of daily living (ADLs), psychological distress (posttraumatic stress disorder [PTSD], depression, and anxiety), and quality of life. Results: Of 408 patients with non-COVID-19 pneumonia (63.4%), 96 patients survived and completed the 12-month follow-up. Among survivors of non-COVID-19 pneumonia, 57.3% met the criteria for LTCI, 13.5% showed executive dysfunction, 17.7% showed impairments in at least 1 basic ADL, 51.0% showed impairments in at least 1 instrumental ADL, 44.0% demonstrated physical disability, 17.8% met the criteria for PTSD, 37.8% met the criteria for depression, 46.7% met the criteria for anxiety, and 19.4% rated their quality of life as poor at 12 months. Interpretation: A substantial proportion of patients with non-COVID-19 pneumonia receiving mechanical ventilation met criteria for LTCI. Additionally, many demonstrated difficulty performing ADLs, showed physical disability, and experienced psychological sequelae, leading to poor quality of life at 12 months. Interventions designed to reduce these adverse outcomes are needed. |
| format | Article |
| id | doaj-art-198191724bd0437da0b76bca63c477e8 |
| institution | DOAJ |
| issn | 2949-7884 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | CHEST Critical Care |
| spelling | doaj-art-198191724bd0437da0b76bca63c477e82025-08-20T02:57:35ZengElsevierCHEST Critical Care2949-78842025-09-013310016110.1016/j.chstcc.2025.100161Long-Term Morbidity Associated With Non-COVID-19 Pneumonia in Patients Receiving Mechanical VentilationTake-Home PointsAlexander T. Clark, MD0Clark I. Strunk, MD1Matthew W. Semler, MD, MSCI2Jonathan D. Casey, MD, MSCI3Cathy A. Jenkins, MS4Guanchao Wang, MS5James C. Jackson, PsyD6E. Wesley Ely, MD, MPH7Amy L. Kiehl, MA8Patsy T. Bryant, MS9Alana Lauck, MS10Stephanie C. DeMasi, MD11Robert E. Freundlich, MD, MSCI12Wesley H. Self, MD, MPH13Rameela Raman, PhD14Jin H. Han, MD15Department of Emergency Medicine, Vanderbilt University Medical Center, Tennessee Valley Healthcare System, Nashville, TNDepartment of Emergency Medicine, Vanderbilt University Medical Center, Tennessee Valley Healthcare System, Nashville, TNDivision of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN; Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TNDivision of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN; Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TNDepartment of Biostatistics, Vanderbilt University Medical Center, Tennessee Valley Healthcare System, Nashville, TNDepartment of Biostatistics, Vanderbilt University Medical Center, Tennessee Valley Healthcare System, Nashville, TNDivision of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN; Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt University Medical Center, Tennessee Valley Healthcare System, Nashville, TN; Geriatric Research, Education, and Clinical Center, Tennessee Valley Healthcare System, Nashville, TNDivision of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN; Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt University Medical Center, Tennessee Valley Healthcare System, Nashville, TN; Geriatric Research, Education, and Clinical Center, Tennessee Valley Healthcare System, Nashville, TNDivision of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN; Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt University Medical Center, Tennessee Valley Healthcare System, Nashville, TNDivision of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN; Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt University Medical Center, Tennessee Valley Healthcare System, Nashville, TNDivision of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN; Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt University Medical Center, Tennessee Valley Healthcare System, Nashville, TNDepartment of Emergency Medicine, Vanderbilt University Medical Center, Tennessee Valley Healthcare System, Nashville, TNDepartment of Anesthesiology, Vanderbilt University Medical Center, Tennessee Valley Healthcare System, Nashville, TNDepartment of Emergency Medicine, Vanderbilt University Medical Center, Tennessee Valley Healthcare System, Nashville, TN; Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TNDepartment of Biostatistics, Vanderbilt University Medical Center, Tennessee Valley Healthcare System, Nashville, TNDepartment of Emergency Medicine, Vanderbilt University Medical Center, Tennessee Valley Healthcare System, Nashville, TN; Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt University Medical Center, Tennessee Valley Healthcare System, Nashville, TN; Geriatric Research, Education, and Clinical Center, Tennessee Valley Healthcare System, Nashville, TN; CORRESPONDENCE TO: Jin H. Han, MDBackground: The COVID-19 pandemic highlighted the impact of acute respiratory illnesses on long-term morbidity. However, the long-term morbidity associated with non-COVID-19 pneumonia is unclear, particularly in patients who are receiving mechanical ventilation. Research Question: What is the burden of 12-month long-term cognitive impairment (LTCI), functional impairment, psychological distress, and quality of life in critically ill patients receiving mechanical ventilation for non-COVID-19 pneumonia? Study Design and Methods: This single-site prospective cohort study enrolled patients with non-COVID-19 pneumonia receiving mechanical ventilation in the emergency department and ICUs from June 18, 2018, through August 30, 2021. Global cognition at 12 months was measured by the Montreal Cognitive Assessment for the Blind, with higher scores representing better cognition. Secondary outcomes were basic and instrumental activities of daily living (ADLs), psychological distress (posttraumatic stress disorder [PTSD], depression, and anxiety), and quality of life. Results: Of 408 patients with non-COVID-19 pneumonia (63.4%), 96 patients survived and completed the 12-month follow-up. Among survivors of non-COVID-19 pneumonia, 57.3% met the criteria for LTCI, 13.5% showed executive dysfunction, 17.7% showed impairments in at least 1 basic ADL, 51.0% showed impairments in at least 1 instrumental ADL, 44.0% demonstrated physical disability, 17.8% met the criteria for PTSD, 37.8% met the criteria for depression, 46.7% met the criteria for anxiety, and 19.4% rated their quality of life as poor at 12 months. Interpretation: A substantial proportion of patients with non-COVID-19 pneumonia receiving mechanical ventilation met criteria for LTCI. Additionally, many demonstrated difficulty performing ADLs, showed physical disability, and experienced psychological sequelae, leading to poor quality of life at 12 months. Interventions designed to reduce these adverse outcomes are needed.http://www.sciencedirect.com/science/article/pii/S2949788425000346anxietycognitionCOVID-19depressionfunctional status post-traumatic stress disordermechanical ventilation |
| spellingShingle | Alexander T. Clark, MD Clark I. Strunk, MD Matthew W. Semler, MD, MSCI Jonathan D. Casey, MD, MSCI Cathy A. Jenkins, MS Guanchao Wang, MS James C. Jackson, PsyD E. Wesley Ely, MD, MPH Amy L. Kiehl, MA Patsy T. Bryant, MS Alana Lauck, MS Stephanie C. DeMasi, MD Robert E. Freundlich, MD, MSCI Wesley H. Self, MD, MPH Rameela Raman, PhD Jin H. Han, MD Long-Term Morbidity Associated With Non-COVID-19 Pneumonia in Patients Receiving Mechanical VentilationTake-Home Points CHEST Critical Care anxiety cognition COVID-19 depression functional status post-traumatic stress disorder mechanical ventilation |
| title | Long-Term Morbidity Associated With Non-COVID-19 Pneumonia in Patients Receiving Mechanical VentilationTake-Home Points |
| title_full | Long-Term Morbidity Associated With Non-COVID-19 Pneumonia in Patients Receiving Mechanical VentilationTake-Home Points |
| title_fullStr | Long-Term Morbidity Associated With Non-COVID-19 Pneumonia in Patients Receiving Mechanical VentilationTake-Home Points |
| title_full_unstemmed | Long-Term Morbidity Associated With Non-COVID-19 Pneumonia in Patients Receiving Mechanical VentilationTake-Home Points |
| title_short | Long-Term Morbidity Associated With Non-COVID-19 Pneumonia in Patients Receiving Mechanical VentilationTake-Home Points |
| title_sort | long term morbidity associated with non covid 19 pneumonia in patients receiving mechanical ventilationtake home points |
| topic | anxiety cognition COVID-19 depression functional status post-traumatic stress disorder mechanical ventilation |
| url | http://www.sciencedirect.com/science/article/pii/S2949788425000346 |
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