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Observational Study
. 2024 Mar;20(1):86-95.
doi: 10.1177/17423953231161333. Epub 2023 Mar 7.

Chronic critical illness in critically ill COVID-19 patients

Burcin Halacli  1 , Mehmet Yildirim  1 , Esat Kivanc Kaya  1 , Ege Ulusoydan  2 , Ebru Ortac Ersoy  1 , Arzu Topeli  1
Affiliations
Observational Study

Chronic critical illness in critically ill COVID-19 patients

Burcin Halacli et al. Chronic Illn. 2024 Mar.

Abstract

Objectives: To evaluate the presence of chronic critical illness (CCI) in COVID-19 patients and compare clinical characteristics and prognosis of patients with and without CCI admitted to intensive care unit (ICU).

Methods: It was a retrospective, observational study at a university hospital ICU. Patients were accepted as CCI if they had prolonged ICU stay (≥14 days) and got ≥1 score for cardiovascular sequential organ failure assessment (SOFA) score and ≥2 score in other parameters on day 14 of ICU admission which was described as persistent organ dysfunction.

Results: 131 of 397 (33%) patients met CCI criteria. CCI patients were older (p = 0.003) and frailer (p < 0.001). Their Acute Physiology and Chronic Health Evaluation (APACHE) II and SOFA scores were higher, PaO2/FiO2 ratio was lower (p < 0.001). Requirement of invasive mechanical ventilation (IMV), steroid use, and septic shock on admission were higher in the CCI group (p < 0.001). CCI patients had higher ICU and hospital mortality than other patients (54.2% vs. 19.9% and 55.7% vs. 22.6%, p < 0.001, respectively). Regression analysis revealed that IMV (OR: 8.40, [5.10-13.83], p < 0.001) and PaO2/FiO2 < 150 on admission (OR: 2.25, [1.36-3.71], p = 0.002) were independent predictors for CCI.

Discussion: One-third of the COVID-19 patients admitted to the ICU were considered as CCI with significantly higher ICU and hospital mortality.

Keywords: Coronavirus; SARS-CoV-2; mortality; outcome; post-intensive care syndrome.

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Conflict of interest statement

Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
ROC curve for predictors of chronic critical illness.
Figure 2.
Figure 2.
Kaplan–Meier survival curve.
See this image and copyright information in PMC

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