This study showed that symptoms of anxiety and depression in people with CRDs were significantly related to lower exercise tolerance levels and higher levels of disease impact. People with increased levels of anxiety and depression have the potential to significantly improve disease impact outcomes post-PR. The results demonstrated that the detection and treatment of anxiety and depression symptoms in people with CRDs are likely to be clinically important.

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OBJECTIVES: Patients discharged from the ICU post-COVID-19 pneumonitis may experience long-term morbidity related to their critical illness, the treatment for this and the ICU environment. The aim of this study was to characterize the cognitive, psychologic, and physical consequences of COVID-19 in patients admitted to the ICU and discharged alive. DESIGN: Prospective cohort study. SETTING: Post-intensive care syndrome (PICS) follow-up clinic at Tallaght University Hospital, a tertiary referral center with a 16-bed mixed medical-surgical ICU, including critical care physicians, a psychologist, a physiotherapist, and a research nurse. PATIENTS: Patients who had been admitted to the ICU in our tertiary referral center with COVID-19 pneumonitis 6 months earlier. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: A total of 22 patients attended the 6-month PICS follow-up clinic following admission to ICU with COVID-19 pneumonitis. Mean grip strength was low at the 6-month follow-up at 24.1 pounds (sd 9.8) with a minimally active median metabolic equivalent (MET) of 970 METs/wk (interquartile range, 0–7,794 METs/wk). Only 59% of patients were independent with regard to their activities of daily living. Eight of 14 patients (57%) had returned to work by 6 months post-ICU discharge. Their mean Intensive Care Psychological Assessment Tool (IPAT) score was 6.6 (sd 4.6) with a Post-Traumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders-5th Edition (PCL-5) score of 21.1 (sd 17.5) and a mean Montreal Cognitive Assessment (MoCA) score of 24 (sd 8.4); suggestive of mild cognitive impairment. In a multivariable regression model, only Acute Physiology and Chronic Health Evaluation II score was significantly independently associated with MoCA score as a cognitive PICS outcome (beta-coefficient, –1.6; se, 0.6; p = 0.04). None of the predictor variables were significantly independently associated with IPAT and PCL-5 as psychologic outcomes, nor with International Physical Activity Questionnaire-Short Form as a physical PICS outcome. CONCLUSIONS: In this single-center prospective cohort study, we found that patients have a high burden of physical and psychologic impairment at 6 months following ICU discharge post-COVID-19 pneumonitis; in many cases requiring specialist referrals for long-term input. We advocate for increased resources for this much needed follow-up multidisciplinary intervention for an ever-growing population of patients.

INTRODUCTION: Health professionals have been subject to increased levels fatigue when compared to population norms. It remains unknown if physiotherapists report high levels of sleep deprivation. This paper explores levels of sleep deprivation, and its potential impact on professional performance. METHODS: A survey was distributed through the Irish Society of Chartered Physiotherapists. The survey explored work characteristics, sleep quality using the Pittsburgh Sleep Quality Index, daytime sleepiness using the Epworth Sleepiness Scale, and the professional and non-professional causes of sleep deprivation in the profession. Pearson correlation and independent t-tests were used on SPSS to explore relationship between variables. RESULTS: There was a total of 559 valid respondents. Females accounted for 82% and public sector employees accounted for 63% of respondents. Over half (50.1%) of respondents said they felt sleep deprivation impacted on their practice. Most physiotherapists (63.3%) of respondents said they did not feel that their practice impacted sleep. The PSQI global score was 5.6 indicating “poor” quality of sleep. The ESS global score was 6.0 indicating ‘higher normal daytime sleepiness’. Potential causes of sleep deprivation included professional issues relating to burnout and work-life balance, and non-professional reasons such as parenthood. DISCUSSION AND CONCLUSION: A mismatch exists between self-reported sleep deprivation and validated measurements of sleep indicating poor self-awareness of the impact of sleep in optimising professional performance. A work-life balance is needed to facilitate a safe and efficient workforce. Individual and organizational efforts should be made to improve sleep quantity and quality to reduce personnel fatigue and enhance physiotherapists professional performance.