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Short-term health-related quality of life, physical function and psychological consequences of severe COVID-19

Authors
  • Carenzo, Luca1
  • Protti, Alessandro1, 2
  • Dalla Corte, Francesca1
  • Aceto, Romina1
  • Iapichino, Giacomo1
  • Milani, Angelo1, 2
  • Santini, Alessandro1
  • Chiurazzi, Chiara1
  • Ferrari, Michele1
  • Heffler, Enrico2, 1
  • Angelini, Claudio1
  • Aghemo, Alessio2, 3
  • Ciccarelli, Michele1
  • Chiti, Arturo2, 1
  • Iwashyna, Theodore J.4
  • Herridge, Margaret S.5
  • Cecconi, Maurizio1, 2
  • 1 Humanitas Clinical and Research Center-IRCCS, Via Manzoni 56, Rozzano, 20089, Italy , Rozzano (Italy)
  • 2 Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Italy , Pieve Emanuele (Italy)
  • 3 Humanitas Clinical and Research Center-IRCCS, Via Manzoni 56, Rozzano, MI, 20089, Italy , Rozzano (Italy)
  • 4 University of Michigan, Ann Arbor, USA , Ann Arbor (United States)
  • 5 Toronto General Research Institute, University of Toronto, Toronto, Canada , Toronto (Canada)
Type
Published Article
Journal
Annals of Intensive Care
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Jun 04, 2021
Volume
11
Issue
1
Identifiers
DOI: 10.1186/s13613-021-00881-x
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundSurvivors of severe COVID-19 are at risk of impaired health-related quality of life (HRQoL) and persistent physical and psychological disability after ICU and hospital discharge. The subsequent social burden is a major concern. We aimed to assess the short-term HRQoL, physical function and prevalence of post-traumatic stress symptoms of invasively mechanically ventilated COVID-19 patients treated in our ICU.MethodsProspective, observational cohort study in a follow-up clinic. Patients completed a 6-min walking test (6MWT) to assess their cardio-pulmonary function around 2 months (early follow-up) from hospital discharge, the EQ-5D-5L questionnaire for quality of life assessment around 2 months and at 6 months from hospital discharge and an anonymous web-based Impact of Event Scale-Revised (IES-R) questionnaire for Post-Traumatic Stress symptoms at 2 months.Results47 patients attended our follow-up program, mean age 59 ± 10 years, median pre-morbid Clinical Frailty Scale (CFS) 2 [2–3]. The median distance walked in 6 min was 470 [406–516] m, 83 [67–99]% of the predicted value. Overall 1 out 3 patients and 4/18 (22%) among those with a good functional baseline prior to COVID-19 (CFS of 1 or 2) had lower (84%) than predicted 6MWT. EQ-5D-5L quality of life VAS was 80 [70–90] out of 100 at early follow-up with a slight improvement to 85 [77.5–90] at 6 months. Mobility, self-care and usual activities improved between the two timepoints, while pain/discomfort and depression/anxiety did not improve or got worse. The IES-R total score was greater than the threshold for concern of 1.6 in 27/41(66%) respondents.ConclusionsPatients recovering from severe COVID-19 requiring invasive mechanical ventilation surviving hospital discharge present with early mild to moderate functional impairment, mildly reduced quality of life from hospital discharge with an overall improvement of mobility, self-care and the ability of performing usual activities, while a worsening of pain and depression/anxiety symptoms at 6 months and a large proportion of symptoms of post-traumatic distress soon after hospital discharge.

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