One of those ongoing health issues may be the result of being on...

One of those ongoing health issues may be the result of being on mechanical ventilation.

Bloomberg Article, link below (may be restricted behind paywall for some).

Life After Ventilators Can Be Hell for Coronavirus Survivors

A follow up on those survivors that successfully come off ventilator support who were part of the compassionate use treatment of Mesoblast's cell therapy Remestemcel-L will reveal whether they are subject to any ongoing weakness as a result of being on a ventilator. As noted in the article many patients who require ventilator support never really recover.

'Mechanical ventilation is a life-saving intervention,” says Hassan Khouli, chair of critical care at the Cleveland Clinic in Ohio. Yet even when patients survive, “some of them will continue to be profoundly weak,” he says. “It can get to the point where they can’t perform daily activities — shaving, taking a bath, preparing a meal — to the point they could be bedridden.’

Some people never fully recover, says Michael Rodricks, medical director of Somerset’s intensive-care unit. And those who do often must relearn basic skills such as walking, talking and swallowing'.

The less time someone is on a ventilator the better the chance of a full recovery. In the compassionate use treatment of critically ill patients using Mesoblast's cell therapy Remestemcel-L 75% (9/12) of those patients successfully came off ventilator support within a median of 10 days. Seven were discharged from the hospital at that time.

'When a person goes on a ventilator, the muscles that typically handle their breathing start to atrophy within hours. Many patients are put on sedatives to make it easier for the machine to take over. But this immobilizes other parts of their body and leads to widespread weakness.

The risk of dying remains higher than average for at least a year after getting off a ventilator, a risk tied to both the number of days spent on the machine and other health conditions the patient had before falling sick.

The worst-case scenario, a condition known as Post-ICU syndrome that can afflict as many as half of Covid-19 patients who survive on a ventilator, says the Cleveland Clinic’s Khouli.“These patients become deconditioned,’’ he says. “Some behave like they are really paralyzed, as if they are quadriplegics. They can barely move their muscles.'.

The quality of life of those patients who come off mechanical ventilation is also of major concern. The phase 2/3 randomised, placebo-controlled trial in 240 patients is likely to follow the patients post hospitalisation. Comparisons are likely to be made on the health of those surviving placebo controlled patients (if any) versus the surviving patients who received Remestemcel-L stem cell therapy.

The indication of those seven patients who recieved Remestemcel-L and were discharged from hospital after seven days would be that they were healthy enough to do so and therefore the benefits of stem cell therapy may extend to curing or reducing those conditions that would be otherwise be had as a result of ongoing mechanical ventilation.

If those 83% of patients saved with Remestemcel-L have a complete recovery in the coming weeks and this is confirmed via the randomised trial there is no doubt that stem cell therapy will be the go to therapy for any ventilator-dependent patient with moderate / severe ARDS.