Physical and psychological impairment in survivors of acute respiratory distress syndrome: a systematic review and meta-analysis

Fazzini, Brigitta; Battaglini, Denise; Carenzo, Luca; Pelosi, Paolo; Cecconi, Maurizio; Puthucheary, Zudin

doi:10.1016/j.bja.2022.08.013

Cited by 20 publications

(12 citation statements)

References 98 publications

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“…42 The prevalence of anxiety, depression, and PTSD was low and quality of life was good. Our results are consistent with previous studies on classical ARDS patients treated 23 or not 24 with ECMO, whereas studies on COVID-19 ECMO population reported a wide range of anxiety prevalence, from 10 to 40%. 34,36 The interaction between physical function and psychological factors play a complex and mostly not fully elucidated role in patient outcomes.…”

Section: Discussionsupporting

confidence: 93%

“…The cognitive and psychological outcomes, such as quality of life, were relatively good and comparable to those reported for ARDS patients managed with or without ECMO. 23,24 When critically ill patients are discharged from ICU, they start walking through a recovery trajectory. During this transition, their quality of life can be burdened by new and unresolving disabilities which affect several areas of physical and mental function.…”

Section: Discussionmentioning

confidence: 99%

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Long-Term Physical, Cognitive, and Psychological Outcomes in Severe COVID-19 Patients Managed With Extracorporeal Membrane Oxygenation: A Prospective Study

Pozzi,

Giani,

Andreossi

et al. 2023

ASAIO Journal

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Extracorporeal membrane oxygenation (ECMO) has been used in highly selected COVID-19 patients with severe respiratory failure. Scarce data exist on long-term outcomes of these patients. We performed a single-center prospective evaluation of consecutive COVID-19 ECMO patients successfully discharged from the intensive care unit between February 2020 and January 2022. Physical, cognitive and psychological outcome was assessed at 3, 6, and 12 months by in-person evaluation. All the 34 discharged patients (median age 49 years old) were alive at one year, and 25 of them were evaluated at the follow-up clinic. 67% of patients had muscle weakness, with improvement over time (p = 0.032). The percentage of patients able to return to work progressively increased, up to 86% at 1 year. 23% of patients experienced fatigue. Participation restriction improved over time for both physical (p = 0.050) and emotional (p = 0.005) problems. Cognitive impairment, anxiety, and depression occurred in 29%, 29%, and 23% of patients, respectively, with no changes over time. Health-related quality of life was good. In conclusion, COVID-19 ECMO patients suffer from significant long-term sequelae. However, multidimensional outcomes continued to improve over the follow-up time.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Long-Term Physical, Cognitive, and Psychological Outcomes in Severe COVID-19 Patients Managed With Extracorporeal Membrane Oxygenation: A Prospective Study

Pozzi,

Giani,

Andreossi

et al. 2023

ASAIO Journal

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“…In comparison with the most recent systematic reviews [40][41][42], we found a similar rate of anxiety (37% ) at the 3-month follow-up. Early post-ICU memories of frightening experiences and post-ICU psychopathology are reported as signi cant risk factors for post-traumatic stress symptoms [43], which might explain our high rates.…”

Section: Discussionsupporting

confidence: 79%

“…In the case of cognitive impairments, our rate of 36% [27 to 46] at 3-month follow-up lies between the two more recent systematic reviews [42,44]it is very similar to an ambispective cohort study of 186 COVID-19 mechanically ventilated patients [4]. We found similar rates of cognitive impairments at the 6-month follow-up to those already reported, although these studies have recruited patients with varying level of severity and have used different instruments for measuring cognitive impairments.…”

Section: Discussionmentioning

confidence: 63%

Six-Month Post-Intensive Care Outcomes During High and Low Bed Occupancy due to the COVID-19 Pandemic: a Multicenter Prospective Cohort Study

Castro-Ávila,

Merino-Osorio,

González-Seguel

et al. 2023

Preprint

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Purpose: The COVID-19 pandemic can be seen as a natural experiment to test how bed occupancy affects post-intensive care unit (ICU) patient's functional outcomes. Therefore, we compared by bed occupancy the frequency of mental, physical, and cognitive impairments in patients admitted to ICU during the COVID-19 pandemic. Methods: Prospective cohort of adults mechanically ventilated >48 hours in one of 19 ICUs in seven Chilean public and private hospitals. Ninety per cent of nationwide beds occupied was the cut-off for low versus high bed occupancy. At ICU discharge, 3- and 6-month follow-up, we assessed disability using the World Health Organization Disability Assessment Schedule 2.0, quality of life, mental, physical, and cognitive outcomes following the core outcome set for acute respiratory failure. Results: 252 eligible participants were enrolled, 103(41%) during low and 149(59%) during high occupancy. Patients treated during high occupancy were younger (P50[P25-P75]: 55[44-63] vs 61[51-71]; p<0.001), more likely to be admitted due to COVID-19 (126[85%] vs 65[63%]; p<0.001), and have higher education qualification (94[63%] vs 48[47%]; p=0.03). No differences were found in the frequency of at least one mental, physical or cognitive impairment by bed occupancy at ICU discharge (low vs high: 93% vs 91%; p=0.6), 3-month (74% vs 63%; p=0.2) and 6-month (57% vs 57%; p=0.9) follow-up. Conclusions: There were no differences in post-ICU outcomes between high and low bed occupancy. Most patients had at least one mental, physical or cognitive impairment at ICU discharge, which remained high at 6-month follow-up.

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“…Short-term memory deficits in COVID-19 reconvalescents can be corroborated by similar impairments in the survivors of other major life-threatening illnesses (such as cancer or HIV) that induce impairments in short-term and working memory, language skills and processing speed ( Peukert et al, 2020 ; Simó et al, 2013 ; Spies et al, 2020 ). Studies of classical (as opposed to COVID-19-related) acute respiratory distress syndrome show that 37–55 % survivors experience impairments in memory and executive functions ( Fazzini et al, 2022 ). A risk factor for cognitive impairments after COVID-19 is intensive care that is necessary for 10 %–20 % of COVID-19 patients ( Jain & Yuan, 2020 ; Rodriguez-Morales et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Attention and memory after COVID-19 as measured by neuropsychological tests: Systematic review and meta-analysis

et al. 2023

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Physical and psychological impairment in survivors of acute respiratory distress syndrome: a systematic review and meta-analysis

Cited by 20 publications

References 98 publications

Long-Term Physical, Cognitive, and Psychological Outcomes in Severe COVID-19 Patients Managed With Extracorporeal Membrane Oxygenation: A Prospective Study

Long-Term Physical, Cognitive, and Psychological Outcomes in Severe COVID-19 Patients Managed With Extracorporeal Membrane Oxygenation: A Prospective Study

Six-Month Post-Intensive Care Outcomes During High and Low Bed Occupancy due to the COVID-19 Pandemic: a Multicenter Prospective Cohort Study

Attention and memory after COVID-19 as measured by neuropsychological tests: Systematic review and meta-analysis

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