Display options
Cite
Schandl A, Hedman A, Lyngå P, et al. Long-term consequences in critically ill COVID-19 patients: A prospective cohort study. Acta Anaesthesiol Scand. 2021;65(9):1285-1292doi: 10.1111/aas.13939.
Schandl, A., Hedman, A., Lyngå, P., Fathi Tachinabad, S., Svefors, J., Roël, M., Geborek, A., Andersson Franko, M., Söderberg, M., Joelsson-Alm, E., & Darlington, P. (2021). Long-term consequences in critically ill COVID-19 patients: A prospective cohort study. Acta anaesthesiologica Scandinavica, 65(9), 1285-1292. https://doi.org/10.1111/aas.13939
Schandl, Anna, et al. "Long-term consequences in critically ill COVID-19 patients: A prospective cohort study." Acta anaesthesiologica Scandinavica vol. 65,9 (2021): 1285-1292. doi: https://doi.org/10.1111/aas.13939
Schandl A, Hedman A, Lyngå P, Fathi Tachinabad S, Svefors J, Roël M, Geborek A, Andersson Franko M, Söderberg M, Joelsson-Alm E, Darlington P. Long-term consequences in critically ill COVID-19 patients: A prospective cohort study. Acta Anaesthesiol Scand. 2021 Oct;65(9):1285-1292. doi: 10.1111/aas.13939. Epub 2021 Jun 25. PMID: 34097753; PMCID: PMC8212104.
Copy Download .nbib Format: NLM
Share it on

Acta Anaesthesiol Scand. 2021 Oct;65(9):1285-1292. doi: 10.1111/aas.13939. Epub 2021 Jun 25.

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

Acta anaesthesiologica Scandinavica

Anna Schandl, Anders Hedman, Patrik Lyngå, Sozan Fathi Tachinabad, Jessica Svefors, Mari Roël, Anne Geborek, Mikael Andersson Franko, Mårten Söderberg, Eva Joelsson-Alm, Pernilla Darlington

Affiliations

  1. Department of Anesthesiology and Intensive Care, Södersjukhuset, Stockholm, Sweden.
  2. Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
  3. Department of Molecular medicine and surgery, Karolinska Institutet, Stockholm, Sweden.
  4. Department of Cardiology, Södersjukhuset, Stockholm, Sweden.
  5. Department of Internal Medicine, Södersjukhuset, Stockholm, Sweden.

PMID: 34097753 PMCID: PMC8212104 DOI: 10.1111/aas.13939

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 post-traumatic 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.

© 2021 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

Keywords: COVID-19; intensive care unit; long-term effects

References

  1. Bi Q, Wu Y, Mei S, et al. Epidemiology and transmission of COVID-19 in 391 cases and 1286 of their close contacts in Shenzhen, China: a retrospective cohort study. Lancet Infect Dis. 2020;20(8):911-919. - PubMed
  2. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239-1242. - PubMed
  3. Shi H, Han X, Jiang N, et al. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infect Dis. 2020;20(4):425-434. - PubMed
  4. Kass DA, Duggal P, Cingolani O. Obesity could shift severe COVID-19 disease to younger ages. Lancet. 2020;395(10236):1544-1545. - PubMed
  5. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-1062. - PubMed
  6. Peckham H, de Gruijter NM, Raine C, et al. Male sex identified by global COVID-19 meta-analysis as a risk factor for death and ITU admission. Nat Commun. 2020;11(1):6317. - PubMed
  7. Kollias A, Kyriakoulis KG, Dimakakos E, Poulakou G, Stergiou GS, Syrigos K. Thromboembolic risk and anticoagulant therapy in COVID-19 patients: emerging evidence and call for action. Br J Haematol. 2020;189(5):846-847. - PubMed
  8. Jonmarker S, Hollenberg J, Dahlberg M, et al. Dosing of thromboprophylaxis and mortality in critically ill COVID-19 patients. Crit Care. 2020;24(1):653. - PubMed
  9. Mao L, Jin H, Wang M, et al. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol. 2020;77(6):683-690. - PubMed
  10. Bowling A. Measuring health: a review of subjective health, well-being and quality of life measurement scales. Maidenhead, UK: Open University Press; 2017. - PubMed
  11. Gerth AMJ, Hatch RA, Young JD, Watkinson PJ. Changes in health-related quality of life after discharge from an intensive care unit: a systematic review. Anaesthesia. 2019;74(1):100-108. - PubMed
  12. Moreno RP, Metnitz PG, Almeida E, et al. SAPS 3-From evaluation of the patient to evaluation of the intensive care unit. Part 2: development of a prognostic model for hospital mortality at ICU admission. Intensive Care Med. 2005;31(10):1345-1355. - PubMed
  13. Hays RD, Sherbourne CD, Mazel RM. The RAND 36-item health survey 1.0. Health Econ. 1993;2(3):217-227. - PubMed
  14. Sullivan M, Taft C. SF-36 Hälsoenkät: Swedish manual and interpretation guide, 2nd edn. Gothenburg: Sahlgrenska University Hospital; 2002. - PubMed
  15. Orwelius L, Nilsson M, Nilsson E, et al. The Swedish RAND-36 health survey - reliability and responsiveness assessed in patient populations using Svensson's method for paired ordinal data. J Patient Rep Outcomes. 2017;2(1):4. - PubMed
  16. Nordlund A, Ekberg K, Kristenson M. EQ-5D in a general population survey-a description of the most commonly reported EQ-5D health states using the SF-36. Qual Life Res. 2005;14(4):1099-1109. - PubMed
  17. Twigg E, Humphris G, Jones C, Bramwell R, Griffiths RD. Use of a screening questionnaire for post-traumatic stress disorder (PTSD) on a sample of UK ICU patients. Acta Anaesthesiol Scand. 2008;52(2):202-208. - PubMed
  18. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361-370. - PubMed
  19. Jutte JE, Needham DM, Pfoh ER, Bienvenu OJ. Psychometric evaluation of the Hospital Anxiety and Depression Scale 3 months after acute lung injury. J Crit Care. 2015;30(4):793-798. - PubMed
  20. Brennan C, Worrall-Davies A, McMillan D, Gilbody S, House A. The Hospital Anxiety and Depression Scale: a diagnostic meta-analysis of case-finding ability. J Psychosom Res. 2010;69(4):371-378. - PubMed
  21. Graham BL, Brusasco V, Burgos F, et al. 2017 ERS/ATS standards for single-breath carbon monoxide uptake in the lung. Eur Respir J. 2017;49:1600016. - PubMed
  22. Wanger J, Clausen JL, Coates A, et al. Standardisation of the measurement of lung volumes. Eur Respir J. 2005;26(3):511-522. - PubMed
  23. Hedenström H, Malmberg P, Agarwal K. Reference values for lung function tests in females. Regression equations with smoking variables. Bull Eur Physiopathol Respir. 1985;21(6):551-557. - PubMed
  24. Hedenström H, Malmberg P, Fridriksson HV. Reference values for lung function tests in men: regression equations with smoking variables. Ups J Med Sci. 1986;91(3):299-310. - PubMed
  25. Han X, Fan Y, Alwalid O, et al. Six-month follow-up chest CT findings after severe COVID-19 pneumonia. Radiology. 2021;299(1):E177-E186. - PubMed
  26. Huang C, Huang L, Wang Y, et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet. 2021;397(10270):220-232. - PubMed
  27. Laboratories ACoPSfCPF. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002;166(1):111-117. - PubMed
  28. Enright PL, Sherrill DL. Reference equations for the six-minute walk in healthy adults. Am J Respir Crit Care Med. 1998;158(5 Pt 1):1384-1387. - PubMed
  29. Bell ML, Fairclough DL, Fiero MH, Butow PN. Handling missing items in the Hospital Anxiety and Depression Scale (HADS): a simulation study. BMC Res Notes. 2016;9(1):479. - PubMed
  30. Valent A, Dudoignon E, Ressaire Q, Dépret F, Plaud B. Three-month quality of life in survivors of ARDS due to COVID-19: a preliminary report from a French academic centre. Anaesth Crit Care Pain Med. 2020;39(6):740-741. - PubMed
  31. Truffaut L, Demey L, Bruyneel AV, et al. Post-discharge critical COVID-19 lung function related to severity of radiologic lung involvement at admission. Respir Res. 2021;22(1):29. - PubMed
  32. Dowdy DW, Eid MP, Dennison CR, et al. Quality of life after acute respiratory distress syndrome: a meta-analysis. Intensive Care Med. 2006;32(8):1115-1124. - PubMed
  33. Davydow DS, Gifford JM, Desai SV, Needham DM, Bienvenu OJ. Posttraumatic stress disorder in general intensive care unit survivors: a systematic review. Gen Hosp Psychiatry. 2008;30(5):421-434. - PubMed
  34. van den Borst B, Peters JB, Brink M, et al. Comprehensive health assessment three months after recovery from acute COVID-19. Clin Infect Dis. 2020. https://doi.org/10.1093/cid/ciaa1750 - PubMed
  35. Svensson P, Hofmann R, Häbel H, Jernberg T, Nordberg P. Association between cardiometabolic disease and severe COVID-19: a nationwide case-control study of patients requiring invasive mechanical ventilation. BMJ Open. 2021;11(2):e044486. - PubMed

MeSH terms

Publication Types