Post-Intensive Care COVID Survivorship Clinic: A Single-Center Experience
Post-Intensive Care COVID Survivorship Clinic: A Single-Center Experience
Blog Article
OBJECTIVES:.Patients discharged from the ICU post-COVID-19 pneumonitis may experience long-term morbidity related to their critical illness, the treatment for this and the ICU environment.The aim of this study was to characterize the cognitive, psychologic, and physical consequences of COVID-19 in patients admitted to the ICU and discharged alive.DESIGN:.
Prospective cohort study.SETTING:.Post-intensive care syndrome (PICS) follow-up clinic at Tallaght University Hospital, a tertiary referral center with a 16-bed mixed medical-surgical ICU, including critical care physicians, a psychologist, a physiotherapist, and a research nurse.PATIENTS:.
Patients who had been admitted to the ICU in our tertiary referral center with COVID-19 pneumonitis 6 months earlier.INTERVENTIONS:.None.MEASUREMENTS AND MAIN RESULTS:.
A total of 22 patients attended the 6-month read more PICS follow-up clinic following admission to ICU with COVID-19 pneumonitis.Mean grip strength was low at the 6-month follow-up at 24.1 pounds (sd 9.8) with a minimally active median metabolic equivalent (MET) of 970 METs/wk (interquartile range, 0–7,794 METs/wk).
Only 59% of patients were independent with regard to their activities of daily living.Eight of 14 patients (57%) had returned to work by 6 months post-ICU discharge.Their offworld drum pads mean Intensive Care Psychological Assessment Tool (IPAT) score was 6.6 (sd 4.
6) with a Post-Traumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders-5th Edition (PCL-5) score of 21.1 (sd 17.5) and a mean Montreal Cognitive Assessment (MoCA) score of 24 (sd 8.4); suggestive of mild cognitive impairment.
In a multivariable regression model, only Acute Physiology and Chronic Health Evaluation II score was significantly independently associated with MoCA score as a cognitive PICS outcome (beta-coefficient, –1.6; se, 0.6; p = 0.04).
None of the predictor variables were significantly independently associated with IPAT and PCL-5 as psychologic outcomes, nor with International Physical Activity Questionnaire-Short Form as a physical PICS outcome.CONCLUSIONS:.In this single-center prospective cohort study, we found that patients have a high burden of physical and psychologic impairment at 6 months following ICU discharge post-COVID-19 pneumonitis; in many cases requiring specialist referrals for long-term input.We advocate for increased resources for this much needed follow-up multidisciplinary intervention for an ever-growing population of patients.