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. 2023 Jan 18;5(1):e0850.
doi: 10.1097/CCE.0000000000000850. eCollection 2023 Jan.

Characteristics of Mid-Term Post-Intensive Care Syndrome in Patients Attending a Follow-Up Clinic: A Prospective Comparison Between COVID-19 and Non-COVID-19 Survivors

Anne-Françoise Rousseau  1   2 , Camille Colson  1 , Pauline Minguet  1 , Isabelle Kellens  1 , Maxine Collard  1 , Camille Vancraybex  1 , Julien Guiot  3 , Bernard Lambermont  1 , Benoit Misset  1
Affiliations

Characteristics of Mid-Term Post-Intensive Care Syndrome in Patients Attending a Follow-Up Clinic: A Prospective Comparison Between COVID-19 and Non-COVID-19 Survivors

Anne-Françoise Rousseau et al. Crit Care Explor. .

Abstract

At present, it is not clear if critically ill COVID-19 survivors have different needs in terms of follow-up compared with other critically ill survivors, and thus if duplicated post-ICU trajectories are mandatory.

Objectives: To compare the post-intensive care syndrome (PICS) of COVID-19 acute respiratory distress syndrome and non-COVID-19 (NC) survivors referred to a follow-up clinic at 3 months (M3) after ICU discharge.

Design setting and participants: Adults who survived an ICU stay greater than or equal to 7 days and attended the M3 consultation were included in this observational study performed in a post-ICU follow-up clinic of a single tertiary hospital.

Main outcomes and measures: Patients underwent a standardized assessment, addressing health-related quality of life (3-level version of EQ-5D), sleep disorders (Pittsburgh Sleep Quality Index [PSQI]), physical status (Barthel index, handgrip and quadriceps strengths), mental health disorders (Hospital Anxiety and Depression Scale and Impact of Event Scale-Revised [IES-R]), and cognitive impairment (Montreal Cognitive Assessment [MoCA]).

Results: A total of 143 survivors (86 COVID and 57 NC) attended the M3 consultation. Their median age and severity scores were similar. NC patients had a shorter ICU stay (10 d [8-17.2 d]) compared with COVID group (18 d [10.8-30 d]) (p = 0.001). M3 outcomes were similar in the two groups, except for a higher PSQI (p = 0.038) in the COVID group (6 [3-9.5]) versus NC group (4 [2-7]), and a slightly lower Barthel index in the NC group (100 [100-100]) than in the COVID group (100 [85-100]) (p = 0.026). However, the proportion of patients with abnormal values at each score was similar in the two groups. Health-related quality of life was similar in the two groups. The three MoCA (≥ 26), IES-R (<33), and Barthel (=100) were normal in 58 of 143 patients (40.6%). In contrast, 68.5% (98/143) had not returned to their baseline level of daily activities.

Conclusions and relevance: In our follow-up clinic at 3 months after discharge, the proportion of patients presenting alterations in the main PICS domains was similar whether they survived a COVID-19 or another critical illness, despite longer ICU stay in COVID group. Cognition and sleep were the two most affected PICS domains.

Keywords: COVID-19; critical illness; outcome assessment; post-intensive care syndrome; survivors.

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Conflict of interest statement

The authors have disclosed that they do not have any potential conflicts of interest.

Figures

Figure 1.
Figure 1.
Flow chart. LOS = length of stay, M3 = 3 mo, NC = non-COVID-19.
Figure 2.
Figure 2.
Proportion of survivors with abnormal results to the questionnaires. HADS-A = Hospital Anxiety and Depression Scale-Anxiety, HADS-D = Hospital Anxiety and Depression Scale-Depression, IES-R = Impact of Event Scale-Revised, MoCA = Montreal Cognitive Assessment, NC = non-COVID-19, PSQI = Pittsburgh Sleep Quality Index.
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