Evaluation of COVID-19 patients receiving long-term oxygen support in the post-COVID period

Abstract

BACKGROUND AND AIM: Persistent physical and medical sequelae, including chronic hypoxemia, may be observed in patients with long-lasting post-COVID syndrome. Long-term oxygen therapy (LTOT) is commonly employed for managing chronic hypoxemia in chronic airway diseases. This study aims to assess the ongoing requirement for LTOT in Coronavirus Disease 2019 (COVID-19) patients during the post-COVID period and to ascertain the persistence of their oxygen therapy needs. METHODS: This cross-sectional, multicentered study included 320 COVID-19 patients who were evaluated for LTOT two months post-discharge. Patient demographics, symptoms at admission, and laboratory and radiological data were retrospectively collected from hospital databases. RESULTS: Continuous oxygen support was necessary for 22.9% of the patients, while 15% of the participants passed away during the post-COVID period. Factors significantly associated with the prolonged need for LTOT included admission to the intensive care unit (ICU), presence of anemia, high serum D-dimer levels (>1000 mu g/L), and low oxygen saturation levels at hospital admission (p=0.026, p=0.011, p=0.010, and p<0.001, respectively). Multivariable regression analysis identified high D-dimer levels (p=0.012) and low oxygen saturation at admission (p<0.001) as the most significant predictors of a continued need for oxygen therapy. Furthermore, advanced age, non-use of steroids in treatment, and mechanical ventilation during hospitalization were significantly linked to mortality during the post-COVID period (p=0.003, p=0.048, and p=0.009, respectively). CONCLUSIONS: ICU admission and certain laboratory parameters can predict the need for LTOT during the post-COVID process. The observation that most COVID-19 patients do not require LTOT after a two-month period suggests that clinicians should adopt a more selective approach in planning LTOT.