The impact of COVID-19 critical illness on new disability, functional outcomes and return to work at 6 months: a prospective cohort study.

Autor: Hodgson CL; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. carol.hodgson@monash.edu.; Department of Intensive Care and Hyperbaric Medicine, The Alfred, Melbourne, Victoria, Australia. carol.hodgson@monash.edu.; Department of Physiotherapy, The Alfred, Melbourne, Victoria, Australia. carol.hodgson@monash.edu.; Department of Critical Care, School of Medicine, University of Melbourne, Victoria, Australia. carol.hodgson@monash.edu., Higgins AM; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia., Bailey MJ; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.; Department of Critical Care, School of Medicine, University of Melbourne, Victoria, Australia., Mather AM; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia., Beach L; Department of Physiotherapy (Allied Health), The Royal Melbourne Hospital, Melbourne, Victoria, Australia., Bellomo R; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.; Department of Critical Care, School of Medicine, University of Melbourne, Victoria, Australia.; Data Analytics Research and Evaluation (DARE) Centre, Austin Hospital, Melbourne, Victoria, Australia., Bissett B; Discipline of Physiotherapy, University of Canberra, Canberra, Australia.; Physiotherapy Department, Canberra Hospital, Canberra, Australia., Boden IJ; Physiotherapy Department, Launceston General Hospital, Launceston, Tasmania, Australia.; Launceston Clinical School, University of Tasmania, Tasmania, Australia., Bradley S; Department of Physiotherapy, The Alfred, Melbourne, Victoria, Australia., Burrell A; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.; Department of Intensive Care and Hyperbaric Medicine, The Alfred, Melbourne, Victoria, Australia., Cooper DJ; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.; Department of Intensive Care and Hyperbaric Medicine, The Alfred, Melbourne, Victoria, Australia., Fulcher BJ; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia., Haines KJ; Physiotherapy Department, Western Health, Melbourne, Victoria, Australia., Hopkins J; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia., Jones AYM; School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia., Lane S; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.; Intensive Care Medicine Nepean Hospital, New South Wales, Australia., Lawrence D; Department of Physiotherapy, The Alfred, Melbourne, Victoria, Australia., van der Lee L; Fiona Stanley Hospital, Perth, Western Australia, Australia., Liacos J; Department of Physiotherapy, The Alfred, Melbourne, Victoria, Australia., Linke NJ; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia., Gomes LM; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia., Nickels M; Physiotherapy Department, Princess Alexandra Hospital, Metro South Health, Queensland, Australia., Ntoumenopoulos G; Physiotherapy, St Vincent's Hospital, Sydney, New South Wales, Australia., Myles PS; Department of Anaesthesiology and Perioperative Medicine, Central Clinical School, Monash University, Melbourne, Victoria, Australia., Patman S; Faculty of Medicine, Nursing and Midwifery, Health Sciences and Physiotherapy, The University of Notre Dame Australia, Perth, Western Australia, Australia., Paton M; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.; Department of Physiotherapy, Monash Health, Melbourne, Victoria, Australia., Pound G; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.; Physiotherapy Department, St Vincent's Hospital, Melbourne, Victoria, Australia., Rai S; Canberra Health Services, Canberra, Australia.; Medical School, Australia National University, Canberra, Australia., Rix A; Department of Physiotherapy, The Alfred, Melbourne, Victoria, Australia., Rollinson TC; Department of Physiotherapy, Division of Allied Health, Austin Health, Melbourne, Australia.; Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia., Sivasuthan J; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia., Tipping CJ; Department of Physiotherapy, The Alfred, Melbourne, Victoria, Australia., Thomas P; Department of Physiotherapy, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia., Trapani T; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia., Udy AA; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.; Department of Intensive Care and Hyperbaric Medicine, The Alfred, Melbourne, Victoria, Australia., Whitehead C; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.; Intensive Care Medicine Nepean Hospital, New South Wales, Australia., Hodgson IT; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia., Anderson S; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia., Neto AS; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.; Department of Physiotherapy (Allied Health), The Royal Melbourne Hospital, Melbourne, Victoria, Australia.; Data Analytics Research and Evaluation (DARE) Centre, Austin Hospital, Melbourne, Victoria, Australia.; Department of Critical Care Medicine, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
Jazyk: angličtina
Zdroj: Critical care (London, England) [Crit Care] 2021 Nov 08; Vol. 25 (1), pp. 382. Date of Electronic Publication: 2021 Nov 08.
DOI: 10.1186/s13054-021-03794-0
Abstrakt: Background: There are few reports of new functional impairment following critical illness from COVID-19. We aimed to describe the incidence of death or new disability, functional impairment and changes in health-related quality of life of patients after COVID-19 critical illness at 6 months.
Methods: In a nationally representative, multicenter, prospective cohort study of COVID-19 critical illness, we determined the prevalence of death or new disability at 6 months, the primary outcome. We measured mortality, new disability and return to work with changes in the World Health Organization Disability Assessment Schedule 2.0 12L (WHODAS) and health status with the EQ5D-5L TM .
Results: Of 274 eligible patients, 212 were enrolled from 30 hospitals. The median age was 61 (51-70) years, and 124 (58.5%) patients were male. At 6 months, 43/160 (26.9%) patients died and 42/108 (38.9%) responding survivors reported new disability. Compared to pre-illness, the WHODAS percentage score worsened (mean difference (MD), 10.40% [95% CI 7.06-13.77]; p < 0.001). Thirteen (11.4%) survivors had not returned to work due to poor health. There was a decrease in the EQ-5D-5L TM utility score (MD, - 0.19 [- 0.28 to - 0.10]; p < 0.001). At 6 months, 82 of 115 (71.3%) patients reported persistent symptoms. The independent predictors of death or new disability were higher severity of illness and increased frailty.
Conclusions: At six months after COVID-19 critical illness, death and new disability was substantial. Over a third of survivors had new disability, which was widespread across all areas of functioning. Clinical trial registration NCT04401254 May 26, 2020.
(© 2021. The Author(s).)
Databáze: MEDLINE
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