by Carol L. Hodgson, Alisa M. Higgins, Michael J. Bailey,
Anne M. Mather, Lisa Beach, Rinaldo Bellomo, Bernie Bissett, Ianthe J. Boden,
Scott Bradley, Aidan Burrell, D. James Cooper, Bentley J. Fulcher, Kimberley J.
Haines, Jack Hopkins, Alice Y. M. Jones, Stuart Lane…
Critical Care volume 25,
Article number: 382 (2021) Published: 08
November 2021
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-5LTM.
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-5LTM 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.
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