tetano
Editor, Senior Moderator
Ann Am Thorac Soc
. 2021 Dec 22.
doi: 10.1513/AnnalsATS.202104-520OC. Online ahead of print.
Post-ICU Syndrome in a Cohort of COVID-19 Survivors in New York City
Karissa Weidman[SUP] 1 [/SUP], Elyse LaFond[SUP] 2 [/SUP], Katherine L Hoffman[SUP] 3 [/SUP], Parag Goyal[SUP] 4 [/SUP], Christopher N Parkhurst[SUP] 5 [/SUP], Heather Derry-Vick[SUP] 6 [/SUP], Edward Schenck[SUP] 7 [/SUP], Lindsay Lief[SUP] 8 [/SUP]
Affiliations
Abstract
Rationale: The coronavirus disease 2019 (COVID-19) pandemic has led to a dramatic increase in the number of survivors of critical illness. These survivors are at increased risk of physical, psychological, and cognitive impairments known collectively as Post-Intensive Care Syndrome (PICS). Little is known about the prevalence of PICS in COVID-19 survivors.
Objectives: To report the prevalence of physical, psychological, and cognitive impairment among COVID-19 intensive care unit (ICU) survivors receiving follow-up care in an ICU recovery clinic, to assess for associations between PICS and ICU-related factors, and to compare the cohort of ICU survivors who attended post-ICU clinic to a cohort of ICU survivors who did not.
Methods: We performed a retrospective cohort study of COVID-19 ICU survivors admitted from March to May 2020 who were subsequently seen in a post-ICU recovery clinic in New York City. We abstracted medical chart data on available clinical screening instruments for physical, psychological, and cognitive impairment. Associations between these outcomes and care-related variables were tested. Baseline characteristics and in-hospital treatments of the post-ICU clinic cohort were compared to COVID-19 ICU survivors from the same institution who were not seen in post-ICU clinic.
Results: 87 COVID-19 ICU survivors were seen in our post-ICU recovery clinic. The median age was 62 years and 74% were male. The median length of hospitalization was 51 days and the median length of ICU stay was 22 days. At the post-ICU follow-up visit, 29%, 21%, and 13% of patients reported clinically significant levels of depressive symptoms, anxiety, and post-traumatic stress disorder symptoms, respectively. 25% had cognitive impairment. The overall prevalence of PICS was 90%. There were no associations between length of ICU stay, delirium, exposure to benzodiazepines, steroids, or systemic paralytics with positive screens for physical, psychological, or cognitive impairment. Baseline characteristics and ICU-related factors were similar in the cohort of COVID-19 ICU survivors who attended ICU recovery clinic and those who did not.
Conclusion: PICS is common in COVID-19 survivors. We did not find any association with length of ICU stay, the use of benzodiazepines, steroids, or paralytics.
. 2021 Dec 22.
doi: 10.1513/AnnalsATS.202104-520OC. Online ahead of print.
Post-ICU Syndrome in a Cohort of COVID-19 Survivors in New York City
Karissa Weidman[SUP] 1 [/SUP], Elyse LaFond[SUP] 2 [/SUP], Katherine L Hoffman[SUP] 3 [/SUP], Parag Goyal[SUP] 4 [/SUP], Christopher N Parkhurst[SUP] 5 [/SUP], Heather Derry-Vick[SUP] 6 [/SUP], Edward Schenck[SUP] 7 [/SUP], Lindsay Lief[SUP] 8 [/SUP]
Affiliations
- PMID: 34936536
- DOI: 10.1513/AnnalsATS.202104-520OC
Abstract
Rationale: The coronavirus disease 2019 (COVID-19) pandemic has led to a dramatic increase in the number of survivors of critical illness. These survivors are at increased risk of physical, psychological, and cognitive impairments known collectively as Post-Intensive Care Syndrome (PICS). Little is known about the prevalence of PICS in COVID-19 survivors.
Objectives: To report the prevalence of physical, psychological, and cognitive impairment among COVID-19 intensive care unit (ICU) survivors receiving follow-up care in an ICU recovery clinic, to assess for associations between PICS and ICU-related factors, and to compare the cohort of ICU survivors who attended post-ICU clinic to a cohort of ICU survivors who did not.
Methods: We performed a retrospective cohort study of COVID-19 ICU survivors admitted from March to May 2020 who were subsequently seen in a post-ICU recovery clinic in New York City. We abstracted medical chart data on available clinical screening instruments for physical, psychological, and cognitive impairment. Associations between these outcomes and care-related variables were tested. Baseline characteristics and in-hospital treatments of the post-ICU clinic cohort were compared to COVID-19 ICU survivors from the same institution who were not seen in post-ICU clinic.
Results: 87 COVID-19 ICU survivors were seen in our post-ICU recovery clinic. The median age was 62 years and 74% were male. The median length of hospitalization was 51 days and the median length of ICU stay was 22 days. At the post-ICU follow-up visit, 29%, 21%, and 13% of patients reported clinically significant levels of depressive symptoms, anxiety, and post-traumatic stress disorder symptoms, respectively. 25% had cognitive impairment. The overall prevalence of PICS was 90%. There were no associations between length of ICU stay, delirium, exposure to benzodiazepines, steroids, or systemic paralytics with positive screens for physical, psychological, or cognitive impairment. Baseline characteristics and ICU-related factors were similar in the cohort of COVID-19 ICU survivors who attended ICU recovery clinic and those who did not.
Conclusion: PICS is common in COVID-19 survivors. We did not find any association with length of ICU stay, the use of benzodiazepines, steroids, or paralytics.
