Quality of life of COVID-19 critically ill survivors after ICU discharge: 90 days follow-up

Abstract

Purpose The onset of the coronavirus disease 19 (COVID-19) pandemic in Italy induced a dramatic increase in the need for intensive care unit (ICU) beds for a large proportion of patients affected by COVID-19-related acute respiratory distress syndrome (ARDS). The aim of the present study was to describe the health-related quality of life (HRQoL) at 90 days after ICU discharge in a cohort of COVID-19 patients undergoing invasive mechanical ventilation and to compare it with an age and sex-matched sample from the general Italian and Finnish populations. Moreover, the possible associations between clinical, demographic, social factors, and HRQoL were investigated. Methods COVID-19 ARDS survivors from 16 participating ICUs were followed up until 90 days after ICU discharge and the HRQoL was evaluated with the 15D instrument. A parallel cohort of age and sex-matched Italian population from the same geographic areas was interviewed and a third group of matched Finnish population was extracted from the Finnish 2011 National Health survey. A linear regression analysis was performed to evaluate potential associations between the evaluated factors and HRQoL. Results 205 patients answered to the questionnaire. HRQoL of the COVID-19 ARDS patients was significantly lower than the matched populations in both physical and mental dimensions. Age, sex, number of comorbidities, ARDS class, duration of invasive mechanical ventilation, and occupational status were found to be significant determinants of the 90 days HRQoL. Clinical severity at ICU admission was poorly correlated to HRQoL. Conclusion COVID-19-related ARDS survivors at 90 days after ICU discharge present a significant reduction both on physical and psychological dimensions of HRQoL measured with the 15D instrument. Trial Registration: NCT04411459. Supplementary Information The online version contains supplementary material available at 10.1007/s11136-021-02865-7.

Health-related quality of life profiles, trajectories, persistent symptoms and pulmonary function one year after ICU discharge in invasively ventilated COVID-19 patients, a prospective follow-up study

“…Missing data for the sexual activity dimension exceeded 20%, despite this aspect is in line with our previous follow-up [11] and data substitution was obtained with the multiple imputation technique, cautious interpretation of these data should be warranted.…”

“…Several factors influenced the slope of HRQoL trajectories. In our previous study at 3 months after ICU discharge [11], we found that increasing age resulted negatively associated with HRQoL scores. Indeed, in the current follow-up, the "bad recovery" cluster showed a higher median age (Table 1).…”

“…The 15D scores are shown to be highly reliable, sensitive and responsive to change, there is a considerable degree of agreement between health state valuations from several European countries [11], and these latter are generalizable at least in Western-type societies [14,16].…”

“…This is the first literature report specifically focusing on ICU survivors who required IMV and our results strengthen the information that more than half of C-ARDS survivors report significant impairment in HRQoL and persistent symptoms, in particular dyspnea, at 1 year after ICU discharge. In fact, despite a significant increase in HRQoL from 3 months to 1 year after ICU discharge being evidenced, only 47.2% of the patients showed a complete recovery at 1 year after ICU discharge with 15D values comparable to those of the general population [11,24].…”

“…This study reports the results of the second follow-up (1 year) of a population of C-ARDS survivors who required ICU admission, intubation, and IMV [10], and who were previously evaluated at 3 months after ICU discharge [11]. The primary objective of this study was to describe the HRQoL trajectories between 3 months and 1 year after ICU discharge.…”