Six-Month Quality of Life in COVID-19 Intensive Care Unit Survivors

Abstract

Objectives: Because there is increasing evidence of serious deterioration in long-term quality of life (QoL) in coronavirus 2019 (COVID-19) intensive care unit (ICU) survivors, the authors identified predictors of poor quality of life in these patients.

Design: Prospective cohort study.

Setting: Research hospital repurposed into a COVID-19 center.

Participants: Consecutive patients admitted in COVID-19 ICUs between March and June 2020.

Interventions: An SF-36 questionnaire, which included physical and mental items, was used six months after patient's discharge.

Measurements and main results: A total of 403 patients were managed in the ICU, with a hospital mortality of 181 of 403 (44.9%), and 16 (4.0%) patients died within six months. Among the 125 questionnaire responders, only 32.0% and 52% had a normal quality of life in terms of the physical and mental component of health. Multivariate analysis identified low-molecular-weight heparin treatment in the ICU as the only modifiable factor associated with an increase in physical component of QoL odds ratio (OR) 3.341 (95% confidence interval 1.298-8.599), p = 0.012, and age ≥52 years OR 0.223 and female sex OR 0.321 were significantly associated with a decrease in the physical component. Medical history of cerebrovascular insufficiency was significantly associated with a decrease in mental component of QoL OR 0.125, and the only factor associated with an increase in the mental health component was body mass index ≥27.6 kg/m² OR 7.466.

Conclusions: In COVID-19 ICU survivors the authors identified treatment with low- molecular-weight heparin as a predictor of improved physical component of QoL at 6 months.

Keywords: COVID-19; Intensive Care; SARS-CoV-2; critical care; low molecular weight heparin; mortality; quality life; quality of life.

Graphical abstract

Fig 1

Flow chart of the study. ICU, intensive care unit.

Fig 2

Receiver operating characteristic analysis: quantitative predictors of the physical (A) and mental (B) components of QoL. BMI, body mass index; QoL; quality of life.

Fig 3

Predictors of physical and mental components of COVID-19 survivors quality of life at a multivariate analysis. BMI, body mass index; COVID-19, coronavirus 2019; ICU, intensive care unit; OR, odds ratio.