Six-Month Impairment in Cognition, Mental Health, and Physical Function Following COVID-19–Associated Respiratory Failure

Autor: Jason H. Maley, MD, MS, Danielle K. Sandsmark, MD, PhD, Alison Trainor, MD, Geoffrey D. Bass, MD, MBA, Cian L. Dabrowski, MS, Brigid A. Magdamo, MSEd, Bridget Durkin, MD, Margaret M. Hayes, MD, Richard M. Schwartzstein, MD, Jennifer P. Stevens, MD, MS, Lewis J. Kaplan, MD, Mark E. Mikkelsen, MD, MSCE, Meghan B. Lane-Fall, MD, MSHP
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Critical Care Explorations, Vol 4, Iss 4, p e0673 (2022)
Druh dokumentu: article
ISSN: 2639-8028
00000000
DOI: 10.1097/CCE.0000000000000673
Popis: OBJECTIVES:. To determine the prevalence and extent of impairments impacting health-related quality of life among survivors of COVID-19 who required mechanical ventilation, 6 months after hospital discharge. DESIGN:. Multicenter, prospective cohort study, enrolling adults 18 years old or older with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection who received mechanical ventilation for 48 hours or more and survived to hospital discharge. Eligible patients were contacted 6 months after discharge for telephone-based interviews from March 2020 to December 2020. Assessments included: Montreal Cognitive Assessment-Blind, Hospital Anxiety and Depression Scale, Impact of Event Scale-6, EuroQOL 5 domain quality-of-life questionnaire, and components of the Multidimensional Dyspnea Profile. SETTING:. Two tertiary academic health systems. PATIENTS:. Of 173 eligible survivors, a random sample of 63 were contacted and 60 consented and completed interviews. INTERVENTIONS:. None. MEASUREMENTS AND MAIN RESULTS:. Mean age was 57 + 13 years and mean duration of invasive mechanical ventilation was 14 + 8.2 days. Six months post-discharge, 48 patients (80%; 95% CI, 68–88%) met criteria for post-intensive care syndrome (PICS), with one or more domains impaired. Among patients with PICS, 28 (47%; 95% CI, 35–59%) were impaired in at least 2 domains, and 12 (20%; 95% CI, 12–32%) impaired in all three domains. Significant symptoms of post-traumatic stress were present in 20 patients (33%; 95% CI, 23–46%), anxiety in 23 (38%; 95% CI, 27–51%), and depression in 25 (42%; 95% CI, 30–54%). Thirty-three patients (55%; 95% CI, 42–67%) had impairments in physical activity; 25 patients (42%; 95% CI, 30–54%) demonstrated cognitive impairment. CONCLUSIONS:. Eighty percent of COVID-19 survivors who required mechanical ventilation demonstrated PICS 6 months after hospital discharge. Patients were commonly impaired in multiple PICS domains as well as coexisting mental health domains.
Databáze: Directory of Open Access Journals
Externí odkaz: