Functional, Pulmonary, Psychological and Cognitive Status Up to 12 Months Post-ICU Discharge in COVID-19 Patients: A Preliminary Analysis of the International Aftercor Study

Abstract Long-term sequelae associated with COVID-19 are currently poorly defined, specifically in patients who have been discharged from intensive care units. We hypothesized that functional and pulmonary capacity, as well as mental health and cognitive function, would remain outside the normal range for up to 12 months after ICU discharge. Methods This is an international multicenter, prospective follow-up study of patients admitted to ICU due to COVID-19 (1). At 3, 6 and 12 months after ICU discharge, the following assessments were done: 6-minute walking test, Barthel Index Score (BIS), WHODAS score, spirometry, lung diffusion capacity for carbon monoxide (DLCO), Hospital Anxiety and Depression Scale (HADS), Patient Health Questionnaire-9 (PHQ-9) and the Montreal Cognitive Assessment (MoCA). Normalized test results at any follow-up assessment were not repeated at subsequent visits. Results 354 patients from 9 sites in 6 countries (Ireland, Spain, Italy, USA, Singapore, Colombia) admitted to ICU from January 2021 to December 2022 for COVID-19 were included. Median (IQR) age was 60 years (SD 13.3y), 32.5% were females, and 22 patients (6.2%) died during follow-up. The 6-min walking test was outside a normal range in 97.7%, 98% and 99.1% of the patients at 3, 6 and 12 months, with a mean walking distance of 359, 392 and 433 meters, respectively (Fig.1A). The BIS score was not normalized in 12.4%, 23.5% and 28% (Fig.1B), the WHODAS score in 22.2%, 56.4% and 45.2% (Fig.1C) at 3, 6 and 12 months, respectively. FVC and FEV1 were outside normal limits in 64.3% of the patients at 3 months, 34.7% and 32.9% at 6 months, 33.8% and 27.7% at 12 months (Fig.1D/E). DLCO was abnormal in 62.4%, 78.4% and 80.6% (Fig.1F) of patients, at 3, 6 and 12 months. As shown by the HADS, anxiety was present in 28.9%, 26.9% and 32.7% (Fig.1G) of the patients, while 30.2%, 26.9% and 32.7% (Fig.1H) had significant depression at 3, 6 and 12 months. The PHQ-9 was outside normal range in 66.4%, 66.2% and 72.2% (Fig 1I) of the patients, while the MOCA test revealed cognitive impairment in 40.8%, 30% and 32.5% of the patients at 3, 6 and 12 months. Conclusion The assessment of COVID-19 patients up to 12 months post-ICU discharge indicates that pulmonary function and mental health remain outside the normal range in a significant proportion of patients, with one-third of patients experiencing cognitive impairment. A comprehensive evaluation of the pre-ICU admission status is currently underway.

Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.