Scientific Reports (May 2022)

Prevalence of post-intensive care syndrome in mechanically ventilated patients with COVID-19

  • Kapil Nanwani-Nanwani,
  • Lorenzo López-Pérez,
  • Carola Giménez-Esparza,
  • Inés Ruiz-Barranco,
  • Elena Carrillo,
  • María Soledad Arellano,
  • Domingo Díaz-Díaz,
  • Beatriz Hurtado,
  • Andoni García-Muñoz,
  • María Ángeles Relucio,
  • Manuel Quintana-Díaz,
  • María Rosario Úrbez,
  • Andrés Saravia,
  • María Victoria Bonan,
  • Francisco García-Río,
  • María Luisa Testillano,
  • Jesús Villar,
  • Abelardo García de Lorenzo,
  • José Manuel Añón

DOI
https://doi.org/10.1038/s41598-022-11929-8
Journal volume & issue
Vol. 12, no. 1
pp. 1 – 11

Abstract

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Abstract Coronavirus disease 19 (COVID-19) patients usually require long periods of mechanical ventilation and sedation, which added to steroid therapy, favours a predisposition to the development of delirium and subsequent mental health disorders, as well as physical and respiratory sequelae. The aim of this study was to determine the prevalence of post-intensive care syndrome (PICS) at 3 months after hospital discharge, in a cohort of mechanically ventilated patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). An ambispective, observational study was conducted in three hospitals with intensive care unit (ICU) follow-up clinics. We studied adults who survived a critical illness due to SARS-CoV-2 infection requiring invasive mechanical ventilation. A physical (muscle strength and pulmonary function), functional [12-Item Short Form Health Survey (SF-12), and Barthel score], psychological [hospital anxiety and depression (HADS) and posttraumatic stress disorder symptom severity scales], and cognitive [Montreal cognitive assessment (MoCA) test] assessment were performed. A total of 186 patients were evaluated at 88 days (IQR 68–121) after hospital discharge. Mean age was 59 ± 12 years old, 126 (68%) patients were men, and median length of mechanical ventilation was 14 days (IQR 8–31). About 3 out of 4 patients (n = 139, 75%) met PICS criteria. Symptoms of cognitive and psychiatric disorders were found in 59 (32%) and 58 (31%) patients, respectively. Ninety-one (49%) patients had muscle weakness. Pulmonary function tests in patients with no respiratory comorbidities showed a normal pattern in 93 (50%) patients, and a restrictive disorder in 62 (33%) patients. Also, 69 patients (37%) were on sick leave, while 32 (17%) had resumed work at the time of assessment. In conclusion, survivors of critical illness due to SARS-CoV-2 infection requiring mechanical ventilation have a high prevalence of PICS. Physical domain is the most frequently damaged, followed by cognitive and psychiatric disorders. ICU follow-up clinics enable the assistance of this vulnerable population.