1. Long-Term Disabilities in ICU Survivors of COVID-19.
- Author
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da Silva KRS, Prazeres DC, Gaspar S, de Souza FG, Chiavegato LD, Leite CF, de Castro SS, Carvalho CR, and Volpe MS
- Subjects
- Humans, Male, Female, Middle Aged, Prospective Studies, Aged, SARS-CoV-2, Critical Illness, Patient Discharge, Disabled Persons, COVID-19 therapy, Respiration, Artificial, Intensive Care Units, Survivors statistics & numerical data, Disability Evaluation
- Abstract
Background: COVID-19 is associated with prolonged disability, particularly after critical illness. This study aimed to assess and compare disability post-hospital discharge of subjects who were invasively ventilated versus those who were not, following ICU admission due to COVID-19. This study also explored variables associated with long-term disability., Methods: In this prospective cohort study, subjects with COVID-19 who received invasive ventilation, noninvasive ventilation, or high-flow nasal cannula during ICU stay were assessed with the World Health Organization Disability Assessment Schedule (WHODAS) 2.0 at 3 and 6 months post-hospital discharge. Data were analyzed collectively and stratified as subjects with and without invasive mechanical ventilation. Analysis of variance and multiple regression analyses were applied., Results: The subjects ( N = 43) were mainly male, middle age, and overweight. Subjects who were invasively ventilated ( n = 21) had decreased physical function compared to those who were not during hospital assessments. From 3-6 months after discharge, all WHODAS domains and the overall score decreased in both groups ( P < .001), indicating disability recovery. The participation domain, which assesses joining in society, was the only domain that remained worse in the ventilation group compared to the no ventilation group ( P = .01). No interaction was found between time and the study groups, suggesting that the recovery trajectory was similar. At 6 months, considering the entire cohort, 70% and 56% had no disability in self-care and getting along domains, respectively, while 42% exhibited moderate to severe disability in the participation domain. According to the overall WHODAS score, 86% of subjects still had some level of disability at 6 months. In multivariate analyses, the overall WHODAS score along with the household and participation domains showed significant positive correlations, indicating higher disability, with corticosteroid use., Conclusions: Disability persisted at 6 month post-hospital discharge for ICU survivors of COVID-19, regardless of the need for invasive mechanical ventilation. Participation was the only domain that showed higher disability among those who received invasive ventilation., Competing Interests: The authors have disclosed no conflicts of interest., (Copyright © 2024 by Daedalus Enterprises.)
- Published
- 2024
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