Implementation of post-intensive care outpatient clinic (I-POINT) for critically ill COVID-19 survivors

Abstract

Although we have enough and cumulative information about acute effects of COVID-19, our knowledge is extremely limited about long-term consequences of COVID-19, in terms of its impacts and burdens on patients, families, and the health system. Considering the underlying pathophysiological mechanisms affecting all of the organ systems in critically ill COVID-19 patients who are admitted to intensive care units, the development of post-intensive care syndrome is inevitable. This situation brings along the development of long-COVID. These patients should be followed regarding cognitive, physical, and psychiatric aspects and necessary specialist referrals should be carried out. In this article, we are presenting the experience and recommendations of our center, as a guide for the establishment process of post-intensive care outpatient clinics for the critically ill patients who required intensive care admission due to COVID-19 and could be discharged.

Keywords: SARS-CoV-2; acute respiratory distress syndrome; outcome; pandemic; long COVID; postintensive care syndrome.

Figure 1

The domains of post-intensive care syndrome (PICS).

Figure 2

I-POINT protocol. ICU LOS: intensive care unit length of stay, ECOG: Eastern Cooperative Oncology Group, CFS: Clinical Frailty Scale, MRC: Medical Research Council, DLCO: Diffusion capacity of carbon monoxide, MNA-SF: Mini Nutritional Assessment Short Form, MMT: Mini-mental test, HADS: Hospital Anxiety and Depression Scale, PTSD-DSM: Post-Traumatic Stress Disorder-Diagnostic and Statistical Manual of Mental Disorders, SF: Short Form.