Long‐term consequences in critically ill COVID‐19 patients: A prospective cohort study

Abstract

Background COVID‐19 can cause severe disease with need of treatment in the intensive care unit (ICU) for several weeks. Increased knowledge is needed about the long‐term consequences. Methods This is a single‐center prospective follow‐up study of COVID‐19 patients admitted to the ICU for respiratory organ support between March and July 2020. Patients with invasive ventilation were compared with those with high‐flow nasal oxygen (HFNO) or non‐invasive ventilation (NIV) regarding functional outcome and health‐related qualify of life. The mean follow‐up time was 5 months after ICU discharge and included clinical history, three well‐validated questionnaires about health‐related quality of life and psychological health, pulmonary function test, 6‐minute walk test (6MWT) and work ability. Data were analyzed with multivariable general linear and logistic regression models with 95% confidence intervals. Results Among 248 ICU patients, 200 patients survived. Of these, 113 patients came for follow‐up. Seventy patients (62%) had received invasive ventilation. Most patients reported impaired health‐related quality of life. Approximately one third suffered from posttraumatic stress, anxiety and depression. Twenty‐six percent had reduced total lung capacity, 34% had reduced 6MWT and 50% worked fulltime. The outcomes were similar regardless of ventilatory support, but invasive ventilation was associated with more bodily pain (MSD ‐19, 95% CI: ‐32 to ‐5) and <80% total lung capacity (OR 4.1, 95% CI: 1.3‐16.5). Conclusion Among survivors of Covid‐19 who required respiratory organ support, outcomes 5 months after discharge from ICU were largely similar among those requiring invasive compared to non‐invasive ventilation.

Lung function and exercise capacity 6 months after hospital discharge for critical COVID-19

“…The 6-min walk is a commonly used measure of exercise capacity for patients with chronic lung disease, which evaluates the responses of the pulmonary and cardiovascular systems, systemic and peripheral circulation, neuromuscular units, and muscle metabolism [ 22 , 34 ]. In our study, the distance patients walked in 6 min was longer than expected compared to the previous studies [ 5 , 6 , 8 , 10 , 28 , 29 ]. The walk distance was below the predicted value only in one-third of the patients, only four patients performed reduced exercise capacity assessed as distance below 80% of predicted, and only two patients performed below the LLN.…”

Post-acute COVID-19 syndrome

“…high-flow nasal cannula or mechanical ventilation) but not with oxygen dependence. However, this association has not been observed in several other studies [ 53 , 58 , 62 , 63 ], including for patients requiring intensive care [ 12 , 63 ].…”

Psychological Symptoms in COVID-19 Patients: Insights into Pathophysiology and Risk Factors of Long COVID-19

“…Some continued experiencing mental consequences that persisted and stayed clinically significant at up to 4 years of follow-up [ 32 ]. Few prospective studies have shown that symptoms of long COVID-19 can persist 3 months [ 87 ], 5 months [ 88 ], 6 months [ 89 , 90 ], and even up to 12 months [ 91 , 92 ] post-hospitalization. Several studies have also shown the presence of psychiatric manifestations post-COVID-19 infection.…”