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
Bibliographic record
Abstract
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.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".