Post-ICU COVID-19 Outcomes

Ramani, Chintan; Davis, Eric M.; Kim, John S.; Provencio, J. Javier; Enfield, Kyle B.; Kadl, Alex

doi:10.1016/j.chest.2020.08.2056

Cited by 52 publications

(69 citation statements)

References 8 publications

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“…To determine an optimal cutoff limit and nonspecific binding in the assay, samples from COVID-19 patients ( n = 51) and samples from allergic and nonallergic donors banked prior to the emergence of COVID-19 ( n = 109) were assayed using ImmunoCAPs conjugated with SARS-CoV-2 protein and also unconjugated “naked” streptavidin ImmunoCAPs. The COVID-19 samples were obtained from the 15 hospitalized patients described above, as well as 36 patients evaluated in an outpatient follow-up clinic following hospitalization for COVID-19 [ 18 ]. IgG binding to naked streptavidin ImmunoCAPs was observed at low levels in both COVID-19 and pre-COVID-19 samples (online suppl.…”

Section: Resultsmentioning

confidence: 99%

Quantitative Measurement of IgG to Severe Acute Respiratory Syndrome Coronavirus-2 Proteins Using ImmunoCAP

Keshavarz

Wiencek

Workman

et al. 2021

Int Arch Allergy Immunol

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Background: Detailed understanding of the immune response to severe acute respiratory syndrome coronavirus (SARS-CoV)-2, the cause of coronavirus disease 2019 (COVID-19) has been hampered by a lack of quantitative antibody assays. Objective: The objective was to develop a quantitative assay for IgG to SARS-CoV-2 proteins that could be implemented in clinical and research laboratories. Methods: The biotin-streptavidin technique was used to conjugate SARS-CoV-2 spike receptor-binding domain (RBD) or nucleocapsid protein to the solid phase of the ImmunoCAP. Plasma and serum samples from patients hospitalized with COVID-19 (n = 60) and samples from donors banked before the emergence of COVID-19 (n = 109) were used in the assay. SARS-CoV-2 IgG levels were followed longitudinally in a subset of samples and were related to total IgG and IgG to reference antigens using an ImmunoCAP 250 platform. Results: At a cutoff of 2.5 μg/mL, the assay demonstrated sensitivity and specificity exceeding 95% for IgG to both SARS-CoV-2 proteins. Among 36 patients evaluated in a post-hospital follow-up clinic, median levels of IgG to spike-RBD and nucleocapsid were 34.7 μg/mL (IQR 18–52) and 24.5 μg/mL (IQR 9–59), respectively. Among 17 patients with longitudinal samples, there was a wide variation in the magnitude of IgG responses, but generally the response to spike-RBD and to nucleocapsid occurred in parallel, with peak levels approaching 100 μg/mL, or 1% of total IgG. Conclusions: We have described a quantitative assay to measure IgG to SARS-CoV-2 that could be used in clinical and research laboratories and implemented at scale. The assay can easily be adapted to measure IgG to mutated COVID-19 proteins, has good performance characteristics, and has a readout in standardized units.

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Section: Resultsmentioning

confidence: 99%

Quantitative Measurement of IgG to Severe Acute Respiratory Syndrome Coronavirus-2 Proteins Using ImmunoCAP

Keshavarz

Wiencek

Workman

et al. 2021

Int Arch Allergy Immunol

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“…These findings add to previous studies reporting a lower prevalence of pulmonary dysfunction in patients with COVID-19. However, these reports were based on less severely ill patients with COVID-19 who were not supported by invasive mechanical ventilation ( 4 ) or who were ventilated for a shorter duration ( 5 ). As such, our data represent the more severe spectrum of COVID-19 disease.…”

Section: Discussionmentioning

confidence: 99%

High Prevalence of Pulmonary Sequelae at 3 Months after Hospital Discharge in Mechanically Ventilated Survivors of COVID-19

Gassel

Bels

Raafs

et al. 2021

Am J Respir Crit Care Med

109

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“…The included patients were overall younger than the general ICU-treated population [8, 23,24]; moreover, patients with PICS impairments tended to use systemic steroids or benzodiazepines, which are known factors for mental and physical PICS [25]. Additionally, long-term health effects across all severities have been recognized in numerous COVID-19 survivors [2,3]. Second, our patients were victims of a new and obscure disease and also a phenomenal pandemic.…”

Section: Mechanismsmentioning

confidence: 99%

“…Although there have been recent reports regarding long-term consequences, including fatigue, insomnia, and anxiety or depression, among COVID-19 survivors at or 6 months after acute infection, information regarding critically ill patients remains missing [2,5, 6]. Small-scale studies investigating ICU treated patients with COVID-19 have suggested that respiratory, mobility, and cognitive consequences are common at approximately a month after hospital discharge [3, 6]. However, PICS occurrence in COVID-19 survivors remains largely unclear.…”

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confidence: 99%

Post-Intensive Care Syndrome Associated With Coronavirus Disease: A Single Institutional Study In Tokyo

Banno

Hifumi

Takahashi

et al. 2021

Preprint

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Background: The occurrence of post-intensive care syndrome (PICS) in critically ill patients with coronavirus disease (COVID-19) remains unclear. This study aimed to investigate the physical, mental, and cognitive components of PICS in intensive care unit (ICU)-treated COVID-19 survivors.Methods: This prospective cohort study enrolled patients with COVID-19 who were treated in the ICU of a single institution between March 19, 2020 and April 30, 2020. A survey was sent by postal mail at 4 and 6 months after ICU discharge. The questionnaire comprised the post-COVID-19 functional status (PCFS) scale and the modified medical research council dyspnea scale (mMRC) for assessing physical PICS; the impact of event scale-revised (IES-R) and the hospital anxiety and depression scale (HADS) for assessing mental PICS; and self-assessment questions for concentration, memory, and forgetfulness for assessing cognitive PICS. Physical PICS was defined by a PCFS or mMRC score ≥1. Mental PICS was defined by an IES-R score ≥25 or if the HADS score for anxiety or depression components was ≥8. Cognitive PICS was defined according to patient complaints of deterioration in concentration, memory, or forgetfulness. The primary outcome was PICS occurrence at 4 months. Moreover, we assessed the co-occurrence of the three PICS components.Results: Twenty patients consented to participate in the study and responded to the survey. The median age was 57.5 years, and 80% of the patients were male; moreover, 50%, 55%, and 80% lived alone, were married, and were employed/self-employed before hospitalization, respectively. During ICU stay, 80%, 75%, and 25% received invasive mechanical ventilation, systemic steroids, and continuous benzodiazepine, respectively. Delirium occurred in 40% of patients. The median days of ICU and hospital stay were 6 and 21, respectively. Physical, mental, and cognitive PICS occurred in 14 (78%), 9 (45%), and 11 (55%) patients, respectively. There were 16 (80%) and 8 (40%) patients with at least one and all PICS components, respectively.Conclusions: Our findings revealed a high rate of PICS in COVID-19 survivors. Long-term and comprehensive evaluation of all three PICS components is crucial for providing appropriate care to these patients.

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Post-ICU COVID-19 Outcomes

Cited by 52 publications

References 8 publications

Quantitative Measurement of IgG to Severe Acute Respiratory Syndrome Coronavirus-2 Proteins Using ImmunoCAP

Quantitative Measurement of IgG to Severe Acute Respiratory Syndrome Coronavirus-2 Proteins Using ImmunoCAP

High Prevalence of Pulmonary Sequelae at 3 Months after Hospital Discharge in Mechanically Ventilated Survivors of COVID-19

Post-Intensive Care Syndrome Associated With Coronavirus Disease: A Single Institutional Study In Tokyo

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