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

2021-11-08

Hodgson, Carol L

Higgins, Alisa M

Bailey, Michael J

Mather, Anne M

Beach, Lisa

Bellomo, Rinaldo

Bissett, Bernie

Boden, Ianthe J

Bradley, Scott

Burrell, Aidan

Cooper, D James

Fulcher, Bentley J

Haines, Kimberley J

Hopkins, Jack

Jones, Alice Y M

Lane, Stuart

Lawrence, Drew

van der Lee, Lisa

Liacos, Jennifer

Linke, Natalie J

Gomes, Lonni Marques

Nickels, Marc

Ntoumenopoulos, George

Myles, Paul S

Patman, Shane

Paton, Michelle

Pound, Gemma

Rai, Sumeet

Rix, Alana

Rollinson, Thomas C

Sivasuthan, Janani

Tipping, Claire J

Thomas, Peter

Trapani, Tony

Udy, Andrew A

Whitehead, Christina

Hodgson, Isabelle T

Anderson, Shannah

Serpa Neto, Ary

COVID-19

Disability

Intensive care

Long-term outcome

Mechanical ventilation

Journal Article

Research Support, Non-U.S. Gov't

0000-0001-9002-2075

0000-0002-1650-8939

0000-0002-5872-9051

10.1186/s13054-021-03794-0

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. 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. 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. 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.

link

Critical Care 2021; 25(1): 382

Critical care (London, England)