Long-term consequences in critically ill COVID-19 patients: a prospective cohort study
Open accessAbstract
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.
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People surviving the acute phases of a severe COVID-19 condition requiring intensive care are at high risk of developing mental health symptoms.
“It has been reported that people surviving the acute phases of a severe COVID-19 condition requiring intensive care are at high risk of developing mental health symptoms.”
In post-critically ill COVID-19 patients, depression, anxiety, and post-traumatic stress were common, occurring in 33-36 percent.
“In particular, depression, anxiety, and post-traumatic stress were common, occurring in 33–36 percent (17).”
A substantial proportion of post-critically ill COVID-19 patients had mental health problems after a median of 5 months.
“One study demonstrated that a substantial proportion of post-critically ill COVID-19 patients had mental health problems after a median of 5 months.”
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Self-citation
- Authors
- 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.
- Affiliations
- Karolinska Institutet (SE)
- Department of Internal Medicine Södersjukhuset Stockholm Sweden
- Stockholm South General Hospital (SE)
- Department of Clinical Science and Education Södersjukhuset Karolinska Institutet Stockholm Sweden
- Corresponding author
- Darlington, Pernilla
- Venue
- Acta Anaesthesiologica Scandinavica
- Publisher
- Wiley
- Published
- 2021-06-25
- Volume
- 65
- Issue
- 9
- Pages
- 1285-1292
- ISSN
- 0001-5172 (ISSN-L)
- 1399-6576
- PMC
- PMC8212104
- OpenAlex
- W3170126859
- Cited by
- 50
- References
- 35
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 11 · 2023: 15 · 2022: 15 · 2021: 3
- FWCI
- 5.26
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Acta Anaesthesiologica Scandinavica (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Keywords
- COVID-19 pandemic, long-term outcomes, intensive care unit survivors, invasive mechanical ventilation, non-invasive ventilation, high-flow nasal cannula, health-related quality of life, post-traumatic stress, anxiety and depression, lung function, total lung capacity, 6-minute walk test, work ability, bodily pain
- MeSH terms
- COVID-19, SARS-CoV-2, Follow-Up Studies, Humans, Intensive Care Units, Prospective Studies, Quality of Life, Critical Illness
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