Clinical Outcomes Among Patients With 1-Year Survival Following Intensive Care Unit Treatment for COVID-19

H. Heesakkers*, J.G. van der Hoeven, S. Corsten, I. Janssen, E. Ewalds, K.S. Simons, B. Westerhof, T.C.D. Rettig, C. Jacobs, S. van Santen, A.J.C. Slooter, M.C.E. van der Woude, M. van den Boogaard, M. Zegers*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

IMPORTANCE One-year outcomes in patients who have had COVID-19 and who received treatment in the intensive care unit (ICU) are unknown.OBJECTIVE To assess the occurrence of physical, mental, and cognitive symptoms among patients with COVID-19 at 1 year after ICU treatment.DESIGN, SETTING, AND PARTICIPANTS An exploratory prospective multicenter cohort study conducted in ICUs of 11 Dutch hospitals. Patients (N = 452) with COVID-19, aged 16 years and older, and alive after hospital discharge following admission to 1 of the 11 ICUs during the first COVID-19 surge (March 1, 2020, until July 1, 2020) were eligible for inclusion. Patients were followed up for 1 year, and the date of final follow-up was June 16, 2021.EXPOSURES Patients with COVID-19 who received ICU treatment and survived 1 year after ICU admission.MAIN OUTCOMES AND MEASURES The main outcomes were self-reported occurrence of physical symptoms (frailty [Clinical Frailty Scale score >= 5], fatigue [Checklist Individual Strength-fatigue subscale score >= 27], physical problems), mental symptoms (anxiety [Hospital Anxiety and Depression {HADS} subscale score >= 8], depression [HADS subscale score >= 8], posttraumatic stress disorder [mean Impact of Event Scale score >= 1.75]), and cognitive symptoms (Cognitive Failure Questionnaire-14 score >= 43) 1 year after ICU treatment and measured with validated questionnaires.RESULTS Of the 452 eligible patients, 301 (66.8%) patients could be included, and 246 (81.5%) patients (mean [SD] age, 61.2 [9.3] years; 176 men [71.5%]; median ICU stay, 18 days [IQR, 11 to 32]) completed the 1-year follow-up questionnaires. At 1 year after ICU treatment for COVID-19, physical symptoms were reported by 182 of 245 patients (74.3% [95% CI, 68.3% to 79.6%]), mental symptoms were reported by 64 of 244 patients (26.2% [95% CI, 20.8% to 32.2%]), and cognitive symptoms were reported by 39 of 241 patients (16.2% [95% CI, 11.8% to 21.5%]). The most frequently reported new physical problems were weakened condition (95/244 patients [38.9%]), joint stiffness (64/243 patients [26.3%]) joint pain (62/243 patients [25.5%]), muscle weakness (60/242 patients [24.8%]) and myalgia (52/244 patients [21.3%]).CONCLUSIONS AND RELEVANCE In this exploratory study of patients in 11 Dutch hospitals who survived 1 year following ICU treatment for COVID-19, physical, mental, or cognitive symptoms were frequently reported.
Original languageEnglish
Pages (from-to)559-565
Number of pages7
JournalJAMA-Journal of the American Medical Association
Volume327
Issue number6
Early online date24 Jan 2022
DOIs
Publication statusPublished - 8 Feb 2022

Keywords

  • HOSPITAL ANXIETY
  • DEPRESSION SCALE
  • RECOVERY
  • ILLNESS
  • FRAILTY
  • IMPACT

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