One-Year Outcomes of Postintensive Care Syndrome in Critically Ill Coronavirus Disease 2019 Patients: A Single Institutional Study

Abstract

Importance: Postintensive care syndrome has a strong impact on coronavirus disease 2019 survivors.

Objectives: Assess the 1-year prevalence of postintensive care syndrome after coronavirus disease 2019.

Design setting and participants: This was a single-center prospective cohort using questionnaires and telephone calls from 4 months to 1 year after ICU discharge. Patients who were treated for coronavirus disease 2019-related acute respiratory distress between March 19, 2020, and April 30, 2020, participated.

Main outcomes and measures: Postintensive care syndrome was evaluated according to physical, mental, and cognitive domains. We surveyed the 8-item standardized Short Form questionnaire for assessing physical postintensive care syndrome; the Impact of Event Scale-Revised and the Hospital Anxiety and Depression Scale for assessing mental postintensive care syndrome; and Short-Memory Questionnaire for assessing cognitive postintensive care syndrome. The primary outcome was postintensive care syndrome occurrence of any domain at 1 year. Furthermore, the co-occurrence of the three postintensive care syndrome domains was assessed.

Results: Eighteen patients consented to the study and completed the survey. The median age was 57.5 years, and 78% of the patients were male. Median Acute Physiology and Chronic Health Evaluation-II score was 18. During ICU stay, 78% received invasive mechanical ventilation, and 83% received systemic steroid administration. Early mobilization was implemented in 61%. Delirium occurred in 44%. The median days of ICU and hospital stay were 6 and 23.5, respectively. Overall postintensive care syndrome occurrence was 67%. Physical, mental, and cognitive postintensive care syndrome occurred in 56%, 50%, and 33% of patients, respectively. The co-occurrence of all three domains of postintensive care syndrome was 28%. Age and Acute Physiology and Chronic Health Evaluation-II scores were higher, and systemic steroids were more commonly used in the postintensive care syndrome groups compared with the nonpostintensive care syndrome groups. Chronic symptoms were more common in the postintensive care syndrome groups than the nonpostintensive care syndrome groups.

Conclusions and relevance: Patients who suffered critical illness from coronavirus disease 2019 had a high frequency of postintensive care syndrome after 1 year. Long-term follow-up and care should be continuously offered.

Keywords: 1 year; coronavirus disease 2019; critical care; intensive care unit; postintensive care syndrome; questionnaire.

Figure 1.

Flow chart of patient selection and exclusion. Eighteen patients completed the study and were enrolled in the analysis.

Figure 2.

The occurrence of physical, mental, and cognitive postintensive care syndrome (PICS). The colored bars show the proportion of patients who were applicable for each domain. Mental PICS was a composite endpoint of anxiety, depression, and post-traumatic stress disorder (PTSD). One patient displayed all three symptoms, and one patient had depression only. PCS = Physical Component Scale, SF-8 = 8-item standardized Short Form, SMQ = Short-Memory Questionnaire.

Figure 3.

Overlapping of each subgroup of postintensive care syndrome (PICS). Physical, mental, and cognitive PICS are displayed by the pink, yellow, and blue circles, respectively. The overlap of the circles represents the co-occurrence of the impairments.