The impact of severe COVID-19 on health-related quality of life and disability: an early follow-up perspective

Abstract

Objective: To assess early postdischarge health-related quality of life and disability of all survivors of critical COVID-19 admitted for more than 24 hours to na intensive care unit.. Methods: Study carried out at the Intensive Care Medicine Department of Centro Hospitalar Universitário São João from 8 th October 2020 to 16 th February 2021. Approximately 1 month after hospital discharge, an intensive care-trained nurse performed a telephone consultation with 99 survivors already at home applying the EuroQol Five-Dimensional Five-Level questionnaire and the 12-item World Health Organization Disability Assessment Schedule 2.0. Results: The mean age of the population studied was 63 ± 12 years, and 32.5% were submitted to invasive mechanical ventilation. Their mean Simplified Acute Physiologic Score was 35 ± 14, and the Charlson Comorbidity Index was 3 ± 2. Intensive care medicine and hospital lengths of stay were 13 ± 22 and 22 ± 25 days, respectively. The mean EuroQol Visual Analog Scale was 65% (± 21), and only 35.3% had no or slight problems performing their usual activities, most having some degree of pain/discomfort and anxiety/depression. The 12-item World Health Organization Disability Assessment Schedule 2.0 showed marked impairments in terms of reassuring usual work or community activities and mobility. The use of both tools suggested that their health status was worse than their perception of it. Conclusion: This early identification of sequelae may help define flows and priorities for rehabilitation and reinsertion after critical COVID-19.

Influence of Deep Sedation in Intensive Care Medicine Memories of Critical COVID-19 Survivors

“…Delusional memories constitute the recall of unpleasant, fearful unreal experiences during ICM stay, such as nightmares and hallucinations, that have previously been associated with suboptimal long-term patient outcomes. 26 , 27 , 33 , 42 , 43 Prominently, the results from this study indicate that deep sedation had a significant, independent association with the incidence of delusional ICM memories, increasing their likelihood by more than 6 times (OR = 6.274; 95% CI = 1.165-33.773, P = .032). This was the most distinct finding arising from this study and is in line with earlier non-COVID ICM-memory studies 27 , 31 as well as recent available data from critical COVID-19 survivors, which have described a significant rate of recall of delusional memories in this population, with reported estimates ranging from 50% to 57%.…”

Return-to-Work Prevalence Among COVID-19 Patients After Receiving Intensive Care: A Systematic Review and Meta-Analysis

“…All the included studies were published from 2021 to 2023 (Table 1 ). Two studies [ 23 , 32 ] were conducted in the United States, 16 in Europe [ 15 , 17 , 18 , 20 - 22 , 24 - 31 , 33 , 34 ], one in Brazil [ 16 ], and one in Australia [ 19 ]. Four studies [ 16 , 25 , 26 , 33 ] assessed return-to-work in patients receiving ECMO.…”

Variáveis Associadas À Incapacidade De Pacientes 12 Meses Após Alta Em Unidades De Terapia Intensiva Covid-19

“…Dessa forma, os sintomas após a internação em UTI por COVID-19 podem ocorrer nos âmbitos físico, mental e cognitivo, impactando negativamente na qualidade de vida (FONTES et al, 2022;ORSINI et al, 2020;HUANG et al, 2021), devido ao comprometimento do funcionamento do sistema respiratório (MANCUZO et al, 2021) e do sistema gastrointestinal (ALMEIDA, CHEHTER, 2020), assim como do sistema hematopoiético, sistema cardiovascular e sistema nervoso central (SILVA et al, 2021). Nesse cenário, a redução da funcionalidade é causada pela disfunção dos músculos do corpo e dos músculos respiratórios, resultando em menor tolerância ao exercício e mobilidade reduzida, o que compromete a realização das Atividades de Vida Diária (AVDs) e afeta tarefas cotidianas como andar, tomar banho e vestir-se, restringindo assim a qualidade de vida desses pacientes (SILVA et al, 2020).…”