What happens “after” respiratory assistance?

Q “Is there a statistic on the survival rate of patients with COVID-19 who are on respiratory assistance? Once we get there, is it worth it? ” asks Sylvain Marcotte, from Quebec. For her part, Marie-Dominique Rouleau, also from Quebec, wonders about what comes after respiratory assistance: “What happens to the lungs of these patients?” Are they permanently damaged? ”
RThere are still no large studies on the survival of patients with COVID-19 who go to intensive care and / or who need respiratory support, since the disease is still very recent, says Dr Patrick Archambault, intensivist and researcher specializing in respiratory diseases at the CHU de Québec. The few data that we have show, as you would expect, very high mortality rates for patients who need to be sent to intensive care. Thus, a very small study carried out by a Seattle team on 21 patients in critical condition showed that 11 of them died [bit.ly/2wSpR7q]. Another Chinese study, says Dr. Archambault, has reported 6 deaths out of 36 intensive care patients,

“Of course these figures can look scary, but we have to put them in perspective,” insists Dr Archambault. They concern only the most ill patients, people on average very old and often suffering from several other serious health problems, so that their mortality rate is necessarily much, much higher than the average. It must be kept in mind that we are talking about a disease here, which gives only mild symptoms (or even no symptoms at all) in at least 80% of cases, and whose general mortality rate seems for l ‘instant be around 1% – although it can vary from country to country.

Now, the question of whether it “is worth it” is up to each patient. But breathing aid itself doesn’t really damage the lungs, says Dr. Archambault: “It’s more the muscle damage that can last in some patients. When you keep someone intubated and bedridden for three or four weeks, all the muscles will atrophy and this can require significant rehabilitation later on. ”

In young patients, muscle recovery is generally rapid, but after 75 or 80 years, the human body makes fewer muscles. “Autonomy and the ability to resume life as before can be strongly affected in this population,” says Dr. Archambault. Note that this is nothing specific to COVID-19: all patients who stay in bed for a long time, for whatever reason, see their muscles atrophy.

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COVID-19 raises a lot of questions. In order to respond to as many people as possible, science journalists have decided to join forces. The media members of the National Cooperative of Independent Information ( Le Soleil, Le Droit, La Tribune, Le Nouvelliste, Le Quotidien and La Voix de l’Est ), Québec Science and the Center Déclic team up to answer your questions . You have some? Write to us . This project is made possible thanks to a contribution from the Chief Scientist of Quebec , who invites you to follow him on Facebook , Twitter and Instagram .

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