CANCOV – Canadian Prospective Cohort of 5-year Outcomes in Critically Ill Patients With COVID-19 Critical Illness and Family Caregivers
Bibliographic record
Abstract
Abstract Rationale: COVID-19 is a novel multisystem disease with unknown long-term morbidity and mortality. Objective: To create a granular dataset of Canadian COVID-19 patients and family caregivers through multidimensional 5-year outcomes and their risk determinants. For COVID ICU survivors, we hypothesize that age, comorbid disease, course in ICU will determine functional/ neuropsychological outcome and healthcare use. Methods: This Canadian, multi-center, ambidirectional cohort study recruited patients and caregivers across the illness spectrum(n=2171). We report on ICU COVID patients ≥ 16y (n=381). Standardized multidimensional follow-up was performed at 3,6,12 and every 6 months to 5 years after ICU discharge. Results: Two-year follow-up was completed in April 2024 and three-year follow-up is ongoing. Baseline characteristics: Hypertension 95%; Obesity: 77%; Diabetes 75%; Dyslipidemia 50%; COPD 44%; mental illness 41%. Median LIS 3.3[3,4]; MODS 10[7, 11] on admission. Median ICU LOS 16d [8, 36] and median hospital LOS 22d[13, 45]. Improving LIS during first 7d of ICU was associated with ICU survival(p<0.007). Overall ICU mortality was 46%. ECMO patients had higher ICU and one-year mortality compared to MV(52% vs 36%; 60% vs 47% respectively).Cohort retention at 12, 24-months; 83%, 86% respectively. Two-year follow-up results: ECMO patients were young (mean 48 y; SD 10), had the fewest comorbidities (median Charlson 1.0 (0.5,1.5), highest prevalence of dialysis 36%;longest duration of continuous sedation(d) (median 21(12,31); narcotics(d)(median 26(14,36); paralytics (d)(median 6(2,18); antibiotics(d)(median 23 (12,35); deep coma (GCS 3)(d) (median18(8,27), MV days (30(15,51), ICU LOS (38 (16,52) and hospital LOS (38(20,66) compared to MV, HFNC and NIV/O2. At 24-months: ECMO/MV and HFNC groups continued to have at least one persistent symptom in > 90%; NIV/O2 was less at 75%. Multidimensional disability (FIM/PCS SF-36, MRC, 6MWD) at 12 -months was unchanged at 24 months. Restrictive PFTs were most marked in the ECMO cohort (TLC, FEV1, FVC % pred median 70,67,68 respectively) and stable. Of 21 patients discharged on home O2, 15/21 remained on home O2 at 24 months. Having any mood disorder decreased between 12 and 24 months for ECMO (36% to 20%), HFNC (28% to 18%) and NIV/O2(0%), but increased for the MV group (33%-52%). Cognitive dysfunction persisted; Stigma remained high and resilience was poor. Healthcare utilization from 12 to 24 months decreased but remained substantial. Comment: In this multi-center sample of severely ill COVID ICU survivors from a Canadian national study, there was important and persistent multidimensional disability to two-year follow-up. ICU survivors of COVID critical illness represent ongoing high-needs healthcare users.
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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) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.003 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 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".