Recovery after prolonged ICU treatment in patients with COVID-19

Parotto, Matteo; Myatra, Sheila Nainan; Munblit, Daniel; Elhazmi, Alyaa; Ranzani, Otávio T.; Herridge, Margaret S.

doi:10.1016/s2213-2600(21)00318-0

Cited by 29 publications

(24 citation statements)

References 10 publications

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“…Any perceived dehumanization of care is likely to increase the risk of post‐traumatic stress symptoms and add to the post critical illness health burden. 3 Data supporting longer‐term mental health impacts is still in its infancy. However, Morin et al, 24 reported anxiety (23%), depression (18%), and PTSD (7%) in 94 patients admitted to ICU post‐COVID‐19 4 months after discharge.…”

Section: Discussionmentioning

confidence: 99%

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Patients' perspectives of recovery after COVID‐19 critical illness: An interview study

Bench

Cherry²,

Hodson

et al. 2022

Nursing in Critical Care

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Background Critical illness is a traumatic experience, often resulting in post‐intensive care syndrome, affecting people's physical, psychological, emotional, and social well‐being. The early recovery period is associated with increased risk, negatively impacting longer‐term outcomes. Aims The aims of this study were to understand the recovery and rehabilitation needs of people who survive a COVID‐19 critical illness. Design and Methods An exploratory descriptive qualitative interview study with 20 survivors of COVID‐19 critical illness from two community‐based healthcare settings in London, England. Data collection took place September 2020–April 2021, at least 1 month after hospital discharge by telephone or virtual platform. Data were subjected to inductive thematic analysis and mapped deductively to the three core concepts of self‐determination theory: autonomy, competence and relatedness. Findings Three key themes emerged: traumatic experience, human connection and navigating a complex system. Participants described how societal restrictions, fear and communication problems caused by the pandemic added to their trauma and the challenge of recovery. The importance of positive human connections, timely information and support to navigate the system was emphasized. Conclusions Whilst findings to some extent mirror those of other qualitative pre‐pandemic studies, our findings highlight how the uncertainty and instability caused by the pandemic add to the challenge of recovery affecting all core concepts of self‐determination (autonomy, competence, relatedness). Relevance to Clinical Practice Understanding survivors' perspectives of rehabilitation needs following COVID‐19 critical illness is vital to delivery of safe, high‐quality care. To optimize chances of effective recovery, survivors desire a specialist, co‐ordinated and personalized recovery pathway, which reflects humanized care. This should be considered when planning future service provisions.

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Section: Discussionmentioning

confidence: 99%

“… 2 To prioritize patient‐centred rehabilitation and recovery interventions for these survivors, there is an urgent need to understand more fully the consequences of having a COVID‐19 critical illness. 3 …”

Section: Introductionmentioning

confidence: 99%

Patients' perspectives of recovery after COVID‐19 critical illness: An interview study

Bench

Cherry²,

Hodson

et al. 2022

Nursing in Critical Care

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“…A better understanding is needed of the impact of a COVID-19 ICU admission on family members to provide adequate support during and after ICU stay [ 9 ]. Therefore, the aim of this study was to measure the prevalence of mental health symptoms and QoL in family members of COVID-19 ICU survivors 3 and 12 months after ICU admission, and to explore risk factors associated with mental health symptoms.…”

Section: Introductionmentioning

confidence: 99%

Mental health symptoms in family members of COVID-19 ICU survivors 3 and 12 months after ICU admission: a multicentre prospective cohort study

Heesakkers¹,

Hoeven²,

Corsten

et al. 2022

Intensive Care Med

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Purpose Long-term mental outcomes in family members of coronavirus disease 2019 (COVID-19) intensive care unit (ICU) survivors are unknown. Therefore, we assessed the prevalence of mental health symptoms, including associated risk factors, and quality of life (QoL) in family members of COVID-19 ICU survivors 3 and 12 months post-ICU. Methods A prospective multicentre cohort study in ICUs of ten Dutch hospitals, including adult family members of COVID-19 ICU survivors admitted between March 1, and July 1, 2020. Symptom prevalence rates of anxiety, depression (Hospital Anxiety and Depression Scale) and Post-Traumatic Stress Disorder (Impact of Event Scale-6), and QoL (Short Form-12) before ICU admission (baseline), and after 3 and 12 months were measured. Additionally, associations between family and patient characteristics and mental health symptoms were calculated. Results A total of 166 out of 197 (84.3%) included family members completed the 12-month follow-up of whom 46.1% and 38.3% had mental health symptoms 3 and 12 months post-ICU, respectively; both higher compared to baseline (22.4%) ( p < 0.001). The mental component summary score of the SF-12 was lower at 12-month follow-up compared with baseline [mean difference mental component score: − 5.5 (95% confidence interval (CI) − 7.4 to − 3.6)]. Furthermore, 27.9% experienced work-related problems. Symptoms of anxiety (odds ratio (OR) 9.23; 95% CI 2.296–37.24; p = 0.002) and depression (OR 5.96; 95% CI 1.29–27.42; p = 0.02) prior to ICU admission were identified as risk factors for mental health symptoms after 12 months. Conclusion A considerable proportion of family members of COVID-19 survivors reported mental health symptoms 3 and 12 months after ICU admission, disrupting QoL and creating work-related problems. Supplementary Information The online version contains supplementary material available at 10.1007/s00134-021-06615-8.

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“…Approximately 21% of COVID‐19 hospitalised patients require care in an intensive care unit (ICU) (Centers for Disease Control and Prevention [CDC], 2022 ) for respiratory and/or cardiovascular complications. Following a COVID‐19 ICU hospitalisation, patients often experience common symptoms such as ongoing cough, shortness of breath, generalised weakness, fatigue, chest pain, memory deficits, confusion, and psychological distress that may take weeks to years to recover from—if at all (Halpin et al, 2020 ; Ogoina et al, 2021 ; Parotto et al, 2021 ). Further, patients who have been discharged from the ICU with health conditions similar to COVID‐19, such as acute respiratory distress syndrome, often require the support of family members to assist in disability management, recovery encouragement, and identification of formal support services (Hauschildt et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Caregiving in the COVID‐19 pandemic: Family adaptations following an intensive care unit hospitalisation

Robinson‐Lane

Leggett

Johnson

et al. 2022

Journal of Clinical Nursing

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Aim and Objective To identify how family caregivers adapt to the caregiving role following a relative's COVID‐19‐related intensive care unit (ICU) hospitalisation. Background Family caregiving is often associated with poor health amongst caregivers which may limit their capacity to effectively support patients. Though severe COVID‐19 infection has necessitated increasing numbers of persons who require caregiver support, little is known about these caregivers, the persons they are caring for, or the strategies used to effectively adjust to the caregiving role. Design A qualitative descriptive study design was adopted, and findings are reported using COREQ. Methods A secondary analysis of transcripts from semi‐structured interviews conducted with recently discharged ICU patients who had COVID‐19 ( n = 16) and their family caregivers ( n = 16) was completed using thematic analysis. MAXQDA 2020 and Miro were used to organise data and complete coding. Analysis involved a structured process of open and closed coding to identify and confirm themes that elucidated adaptation to family caregiving. Results Six themes highlight how family caregivers adapt to the caregiving role following an ICU COVID‐19‐related hospitalisation including (1) engaging the support of family and friends, (2) increased responsibilities to accommodate caregiving, (3) managing emotions, (4) managing infection control, (5) addressing patient independence and (6) engaging support services. These themes were found to be congruent with the Roy adaptation model. Conclusions Family caregiving is a stressful transition following a patient's acute hospitalisation. Effective adaptation requires flexibility and sufficient support, beginning with the care team who can adequately prepare the family for the anticipated challenges of recovery. Relevance to Clinical Practice Clinical teams may improve post‐hospitalisation care outcomes of patients by preparing families to effectively adjust to the caregiver role—particularly in identifying sufficient support resources. Patient or Public Contribution Participation of patients/caregivers in this study was limited to the data provided through participant interviews.

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Recovery after prolonged ICU treatment in patients with COVID-19

Cited by 29 publications

References 10 publications

Patients' perspectives of recovery after COVID‐19 critical illness: An interview study

Patients' perspectives of recovery after COVID‐19 critical illness: An interview study

Mental health symptoms in family members of COVID-19 ICU survivors 3 and 12 months after ICU admission: a multicentre prospective cohort study

Caregiving in the COVID‐19 pandemic: Family adaptations following an intensive care unit hospitalisation

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