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Post intensive care syndrome in survivors of COVID-19 who required mechanical ventilation during the third wave of the pandemic: A prospective study

BACKGROUND: Post intensive care syndrome is defined as the presence of any impairment affecting the physical, psychiatric, or cognitive domains as a result of critical illnesses. OBJECTIVES: To explore functional, cognitive and psychological outcomes at 30 days post hospital discharge among survivor...

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Detalles Bibliográficos
Autores principales: Martínez, Ezequiel, Aguilera, Cintia, Márquez, Diego, Ziegler, Gabriela, Plumet, Javier, Tschopp, Lorena, Cominotti, Claudia, Sturzenegger, Viviana, Cimino, Carlos, Escobar, Hernán, Pereyra, Cecilia, Hidalgo, Eliana, Adanza, Santiago Piombi, Morelli, Daniela Moraes, Masevicius, Fabio Daniel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10277848/
https://www.ncbi.nlm.nih.gov/pubmed/37348211
http://dx.doi.org/10.1016/j.hrtlng.2023.06.021
Descripción
Sumario:BACKGROUND: Post intensive care syndrome is defined as the presence of any impairment affecting the physical, psychiatric, or cognitive domains as a result of critical illnesses. OBJECTIVES: To explore functional, cognitive and psychological outcomes at 30 days post hospital discharge among survivors of COVID-19–associated acute respiratory distress syndrome, who required mechanical ventilation. METHODS: Prospective cohort study. We included adult patients with COVID-19–associated acute respiratory distress syndrome, invasively ventilated in two ICUs in Buenos Aires. We measured functional, cognitive and psychological impairments with Barthel index, Montreal Cognitive Assessment test, Patient Health Questionnaire-9 and General Anxiety Disorder-7. Primary outcome was post-intensive care syndrome. Secondary outcome was mortality at 60 days. RESULTS: We admitted 40 patients, median age was 69 (60–75) and mostly male (75%). Mortality at 60 days was 37%. Cox regression analysis identified diabetes and Apache II as independent predictors of mortality. Out of 22 patients studied, 14 (64%) developed PICS after discharge. With a physical, cognitive and psychological impairment in 64%, 41% and 32% of patients, respectively. Obesity, days of mechanical ventilation, Apache II, vasopressors use, delirium duration and cumulative midazolam dose were associated with functional dependence. CONCLUSIONS: We identified a high prevalence of functional, cognitive and mental impairment at 30 days after hospital discharge in COVID-19–associated acute respiratory distress syndrome survivors, invasively ventilated. The physical domain was the most frequently affected. These findings suggest the need for long-term follow-up of this population.