Six-Month Outcomes in COVID-19 ICU Patients and Their Family Members: A Prospective Cohort Study

Abstract

Background: The COVID-19 pandemic has resulted in a major influx of intensive care unit (ICU) admissions. Currently, there is limited knowledge on the long-term outcomes of COVID-19 ICU-survivors and the impact on family members. This study aimed to gain an insight into the long-term physical, social and psychological functioning of COVID-19 ICU-survivors and their family members at three- and six-months following ICU discharge. Methods: A single-center, prospective cohort study was conducted among COVID-19 ICU-survivors and their family members. Participants received questionnaires at three and six months after ICU discharge. Physical functioning was evaluated using the MOS Short-Form General Health Survey, Clinical Frailty Scale and spirometry tests. Social functioning was determined using the McMaster Family Assessment Device and return to work. Psychological functioning was assessed using the Hospital Anxiety and Depression Scale. Results: Sixty COVID-19 ICU-survivors and 78 family members participated in this study. Physical functioning was impaired in ICU-survivors as reflected by a score of 33.3 (IQR 16.7–66.7) and 50 (IQR 16.7–83.3) out of 100 at 3- and 6-month follow-ups, respectively. Ninety percent of ICU-survivors reported persistent symptoms after 6 months. Social functioning was impaired since 90% of COVID-19 ICU-survivors had not reached their pre-ICU work level 6 months after ICU-discharge. Psychological functioning was unaffected in COVID-19 ICU-survivors. Family members experienced worse work status in 35% and 34% of cases, including a decrease in work rate among 18.3% and 7.4% of cases at 3- and 6-months post ICU-discharge, respectively. Psychologically, 63% of family members reported ongoing impaired well-being due to the COVID-19-related mandatory physical distance from their relatives. Conclusion: COVID-19 ICU-survivors suffer from a prolonged disease burden, which is prominent in physical and social functioning, work status and persisting symptoms among 90% of patients. Family members reported a reduction in return to work and impaired well-being. Further research is needed to extend the follow-up period and study the effects of standardized rehabilitation in COVID-19 patients and their family members.

Mental health symptoms in family members of COVID-19 ICU survivors 3 and 12 months after ICU admission: a multicentre prospective cohort study

“…Reported HADS scores at 3-month follow-up in a comparable study in family members of COVID-19 ICU patients seem somewhat lower compared with our results (HADS-A: median 3 [IQR 2–7] versus median 5 [IQR 2–8] and HADS-D: median 2 [IQR 1–6] versus median 3 [IQR 0.5–8]) [ 22 ]. However, this single centre study, included less family members of COVID-19 ICU survivors ( N = 78) and did not report the prevalence of mental health symptoms before ICU admission, which is strongly associated with long-term outcomes, and therefore important for the interpretation of the results.…”

“…All questionnaires are validated in Dutch, recommended [ 19 ] and numerously used in family members of COVID-19 and non-COVID-19 ICU survivors [ 11 , 17 , 20 – 22 ]. Demographics of the family members (e.g.…”

Prevalence of fatigue at one-year follow-up from the Gothenburg recovery and rehabilitation after COVID-19 and intensive care unit study

“…In Sweden, approximately 1.8% of those who tested positive for COVID-19 16 , and 16.2% of those hospitalized for COVID-19, required care in an Intensive Care Unit (ICU) 17 . In individuals requiring ICU care, the prevalence of fatigue was 72% at 4–8 weeks 18 , while up to 16% reported fatigue at 3–6 months after ICU admission 19 . When individuals admitted to the ICU were compared with individuals admitted to a ward due to COVID-19, no differences were found in terms of fatigue 11 days after COVID-19 15 .…”

Long-Term Consequences of COVID-19 at 6 Months and Above: A Systematic Review and Meta-Analysis

“…Among the 193 studies under full-text review, 153 studies were excluded. Eventually, 40 studies were included in this meta-analysis based on the inclusion criteria [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 ]. The literature retrieval flow chart is shown in Figure 1 .…”