Assessing Whether Patients Need Long-Term Oxygen Therapy After COVID-19

Because most patients who have experienced a COVID-19 infection do not require the use of long-term oxygen therapy (LTOT) in the post-disease period, clinicians likely need consider the use of less permanent oxygen therapy options and ensure that patients receive frequent control visits to monitor their oxygen needs. These were among the results of research presented at the CHEST 2021 Annual Meeting, held virtually October 17 to 20.

Recognizing that post-COVID medical sequelae can include chronic hypoxemia, the researchers conducted a multicenter, cross-sectional study to assess patients who were using LTOT in the post-COVID period, evaluating whether the need for oxygen support persisted. The investigators questioned a total of 320 patients with COVID-19 at the control visit, at which time they retrospectively recorded, from the hospital database, patient demographics, laboratory and radiologic findings, and admission symptoms.

Among the 320 patients, 189 were men and 131 were women. The mean participant age was 70.6±12.6 years. For evaluation purposes, the average visit time was 2.03±1.39 months. Of the patients who were assessed, 15% died during the post-COVID process, with a statistically significant association of mortality associated with older age

(P =.003), the use of mechanical ventilation (P =.019), and the lack of steroid administration during hospitalization (P =.048).

Oxygen support continued to be required among 22.9% of the participants. Significant risk factors for the ongoing need for home oxygen support included a high serum

D-dimer level (ie, of greater than1000/µg; P =.010) and admission to the intensive care unit (P = .026).  oxygen saturation at hospitalization was shown to be significantly lower among patients who continued to require oxygen therapy vs those who did not (P <.001).

The researchers concluded that based on the fact that most individuals who have experienced a COVID-19 infection do not require LTOT in the post-disease period, healthcare professionals need to be more selective in their decision to recommend such therapy and control visits for these patients should occur more often. Researchers also noted that for many of these patients, in place of using a permanent device such as an oxygen concentrator, the use of a temporary device such as an oxygen tank may be preferred.

Disclosure: None of the study authors have declared affiliations with biotech, pharmaceutical, and/or device companies.

Reference                                                                                                                                    

Onur M, Fulsen T, Ozgur B, et al. Evaluation of patients with COVID-19 receiving long-term oxygen support in post-COVID period. CHEST. 2021;160(4 suppl):A2348-A2349.