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Multicenter Study
. 2021 Nov-Dec:189:106665.
doi: 10.1016/j.rmed.2021.106665. Epub 2021 Oct 22.

Health-related quality of life profiles, trajectories, persistent symptoms and pulmonary function one year after ICU discharge in invasively ventilated COVID-19 patients, a prospective follow-up study

Lorenzo Gamberini  1 , Carlo Alberto Mazzoli  1 , Irene Prediletto  2 , Harri Sintonen  3 , Gaetano Scaramuzzo  4 , Davide Allegri  5 , Davide Colombo  6 , Tommaso Tonetti  7 , Gianluca Zani  8 , Chiara Capozzi  9 , Giorgia Dalpiaz  10 , Vanni Agnoletti  11 , Iacopo Cappellini  12 , Gabriele Melegari  13 , Federica Damiani  14 , Maurizio Fusari  8 , Giovanni Gordini  1 , Cristiana Laici  15 , Maria Concetta Lanza  16 , Mirco Leo  17 , Andrea Marudi  13 , Raffaella Papa  18 , Antonella Potalivo  19 , Jonathan Montomoli  19 , Stefania Taddei  20 , Massimiliano Mazzolini  21 , Anna Filomena Ferravante  22 , Roberta Nicali  23 , Vito Marco Ranieri  7 , Emanuele Russo  11 , Carlo Alberto Volta  4 , Savino Spadaro  4 ; ICU-RER COVID-19 Collaboration; Radiology Collaborators (to be indexed and searchable into PubMed); Pneumology Collaborators (to be indexed and searchable into PubMed)
Collaborators, Affiliations
Multicenter Study

Health-related quality of life profiles, trajectories, persistent symptoms and pulmonary function one year after ICU discharge in invasively ventilated COVID-19 patients, a prospective follow-up study

Lorenzo Gamberini et al. Respir Med. 2021 Nov-Dec.

Abstract

Background: Health-related quality of life (HRQoL) impairment is often reported among COVID-19 ICU survivors, and little is known about their long-term outcomes. We evaluated the HRQoL trajectories between 3 months and 1 year after ICU discharge, the factors influencing these trajectories and the presence of clusters of HRQoL profiles in a population of COVID-19 patients who underwent invasive mechanical ventilation (IMV). Moreover, pathophysiological correlations of residual dyspnea were tested.

Methods: We followed up 178 survivors from 16 Italian ICUs up to one year after ICU discharge. HRQoL was investigated through the 15D instrument. Available pulmonary function tests (PFTs) and chest CT scans at 1 year were also collected. A linear mixed-effects model was adopted to identify factors associated with different HRQoL trajectories and a two-step cluster analysis was performed to identify HRQoL clusters.

Results: We found that HRQoL increased during the study period, especially for the significant increase of the physical dimensions, while the mental dimensions and dyspnea remained substantially unchanged. Four main 15D profiles were identified: full recovery (47.2%), bad recovery (5.1%) and two partial recovery clusters with mostly physical (9.6%) or mental (38.2%) dimensions affected. Gender, duration of IMV and number of comorbidities significantly influenced HRQoL trajectories. Persistent dyspnea was reported in 58.4% of patients, and weakly, but significantly, correlated with both DLCO and length of IMV.

Conclusions: HRQoL impairment is frequent 1 year after ICU discharge, and the lowest recovery is found in the mental dimensions. Persistent dyspnea is often reported and weakly correlated with PFTs alterations.

Trial registration: NCT04411459.

Keywords: Acute respiratory distress syndrome; COVID-19; Dyspnea; Health-related quality of life; Respiratory function tests.

PubMed Disclaimer

Conflict of interest statement

Harri Sintonen is the developer of the 15D and obtains royalties from its electronic versions. The other Authors have nothing to disclose.

Figures

Fig. 1
Fig. 1
Health-related quality of life profiles at 3 months and 1 year after ICU discharge. Notes: asterisks highlight the dimensions significantly different between 3 months and 1 year. Abbreviations: Move – mobility; See – vision; Hear – hearing; Breath – breathing; Sleep – sleeping; Eat – eating; Speech – speech; Excret – excretion; Uact – usual activities; Mental – mental function; Disco – discomfort; Depr – depression; Distr – distress; Vital – Vitality; Sex – sexual activity.
Fig. 2
Fig. 2
Comparison of the 1-year health-related quality of life profiles clusters. Notes: the blue dashed lines highlight the significant differences between the partial recovery-mental and the partial recovery-physical groups. Abbreviations: Move – mobility; See – vision; Hear – hearing; Breath – breathing; Sleep – sleeping; Eat – eating; Speech – speech; Excret – excretion; Uact – usual activities; Mental – mental function; Disco – discomfort; Depr – depression; Distr – distress; Vital – Vitality; Sex – sexual activity. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
supplement Fig. 1
supplement Fig. 1
See this image and copyright information in PMC

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