No abstract

IntroductionLimited evidence exists on the health-related quality of life and the socio-economic impact of disease in critically-ill, COVID-19 survivors. Aims of this study were to: assess the quality of life of survivors after ICU discharge; identify social and disease-related risk factors for long-term health consequences; recognize changes in relational, work and economic skills.MethodsCritically ill ARDS survivors were followed up 6 months after ICU discharge. Quality of life was assessed using validated tools (SF-36 and EuroQol EQ-5D-5L), and the socio-economic burden of COVID-19 was evaluated with a specifically-translated questionnaire. Independent sample analysis and regression analysis were performed to evaluate the associations between the evaluated factor and the quality of life.Results79 survivors were enrolled (age 63 [57-71], 84% male). 38.4% report worsened social relations after ICU discharge; 15.4% required health support, 42% had a change in their employment status and 18% had an income reduction. The average physical and mental SF-36 summary scores were 43.6 [34.4-50.2] and 52.1 [44.5-57.0]. The average EQ VAS quality of life score was 80 [60-89]. Reduced quality of life was found in patients with more than one comorbidity, decreased PaO2/FiO2 (≤ 150) and increased SAPS II score (>25) on ICU admission, and prolonged hospital length of stay (LOS) > 4 weeks. The univariate analysis identified hospital LOS, SAPS II, age and two or more comorbidities as factors associated with reduced quality of life.ConclusionsCOVID-19 survivors have a reduced quality of life, due to an impaired physical and cognitive functioning, while anxiety and depression are less frequent. A significant proportion of patients report worsened social relations, employment changes and income reduction, and require health and financial support. People with previous comorbidities, most severe respiratory failure and prolonged hospital and ICU stay are at higher risk of health-related problems, while the level of education and the premorbid income have no impact in this cohort.