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Observational Study
. 2023 Oct;38(10):931-938.
doi: 10.1177/08850666231174375. Epub 2023 May 8.

Discharge Disposition and Loss of Independence Among Survivors of COVID-19 Admitted to Intensive Care: Results From the SCCM Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS)

Shahla Siddiqui  1 , Lauren Kelly  1 , Nicholas Bosch  2 , Anica Law  2 , Love A Patel  3 , Nicholas Perkins  4 , Donna Lee Armaignac  5 , Igor Zabolotskikh  6 , Amy Christie  7 , Surapaneni Krishna Mohan  8 , Neha Deo  9 , Vikas Bansal  9 , Vishaka K Kumar  10 , Ognjen Gajic  9 , Rahul Kashyap  9 , Juan Pablo Domecq  9 , Karen Boman  10 , Allan Walkey  2 , Valerie Banner-Goodspeed  1 , Maximilian Sebastian Schaefer  1   11
Affiliations
Observational Study

Discharge Disposition and Loss of Independence Among Survivors of COVID-19 Admitted to Intensive Care: Results From the SCCM Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS)

Shahla Siddiqui et al. J Intensive Care Med. 2023 Oct.

Abstract

Objectives: To describe incidence and risk factors of loss of previous independent living through nonhome discharge or discharge home with health assistance in survivors of intensive care unit (ICU) admission for coronavirus disease 2019 (COVID-19).

Design: Multicenter observational study including patients admitted to the ICU from January 2020 till June 30, 2021.

Hypothesis: We hypothesized that there is a high risk of nonhome discharge in patients surviving ICU admission due to COVID-19.

Setting: Data were included from 306 hospitals in 28 countries participating in the SCCM Discovery Viral Infection and Respiratory Illness Universal Study COVID-19 registry.

Patients: Previously independently living adult ICU survivors of COVID-19.

Interventions: None.

Measurements and main results: The primary outcome was nonhome discharge. Secondary outcome was the requirement of health assistance among patients who were discharged home. Out of 10 820 patients, 7101 (66%) were discharged alive; 3791 (53%) of these survivors lost their previous independent living status, out of those 2071 (29%) through nonhome discharge, and 1720 (24%) through discharge home requiring health assistance. In adjusted analyses, loss of independence on discharge among survivors was predicted by patient age ≥ 65 years (adjusted odds ratio [aOR] 2.78, 95% confidence interval [CI] 2.47-3.14, P < .0001), former and current smoking status (aOR 1.25, 95% CI 1.08-1.46, P = .003 and 1.60 (95% CI 1.18-2.16), P = .003, respectively), substance use disorder (aOR 1.52, 95% CI 1.12-2.06, P = .007), requirement for mechanical ventilation (aOR 4.17, 95% CI 3.69-4.71, P < .0001), prone positioning (aOR 1.19, 95% CI 1.03-1.38, P = .02), and requirement for extracorporeal membrane oxygenation (aOR 2.28, 95% CI 1.55-3.34, P < .0001).

Conclusions: More than half of ICU survivors hospitalized for COVID-19 are unable to return to independent living status, thereby imposing a significant secondary strain on health care systems worldwide.

Keywords: critical illness; discharge; independent; rehabilitation; survivors.

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Conflict of interest statement

The 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.
Cohort of VIRUS registry patients with COVID-19.
Figure 2.
Figure 2.
Change in nonhome discharge percentage over time with 7-day average coronavirus disease 2019 (COVID-19) patient infections/100 000 population in the Americas (including middle and South America).
See this image and copyright information in PMC

References

    1. Berian JR, Mohanty S, Ko CY, Rosenthal RA, Robinson TN. Association of loss of independence with readmission and death after discharge in older patients after surgical procedures. JAMA Surg. 2016;151(9):e161689. - PubMed
    1. Kazaure HS, Roman SA, Sosa JA. Association of postdischarge complications with reoperation and mortality in general surgery. Arch Surg. 2012;147(11):1000-1007. - PubMed
    1. Xie J, Wu W, Li S, et al.Clinical characteristics and outcomes of critically ill patients with novel coronavirus infectious disease (COVID-19) in China: a retrospective multicenter study. Intensive Care Med. 2020;46(10):1863-1872. doi:10.1007/s00134-020-06211-2 - DOI - PMC - PubMed
    1. Nandasena HMRKG, Pathirathna ML, Atapattu AMMP, et al.Quality of life of COVID 19 patients after discharge: systematic review. PLoS One. 2022;17(2):e0263941. doi:10.1371/journal.pone.0263941. PMID: 35171956; PMCID: PMC8849513. - DOI - PMC - PubMed
    1. Domecq JP, Lal A, Sheldrick CR, et al.Outcomes of patients with coronavirus disease 2019 receiving organ support therapies: the International Viral Infection and Respiratory Illness Universal Study Registry. Crit Care Med. 2021;49(3):437-448. doi:10.1097/CCM.0000000000004879. Erratum in: Crit Care Med. 2021 May 1;49(5):e562. PMID: 33555777. - DOI - PMC - PubMed

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