The impact of COVID-19 critical illness on new disability, functional outcomes and return to work at 6 months: a prospective cohort study
Abstract Background There are few reports of new functional impairment following critical illness from COVID-19. We aimed to describe the incidence of death or new disability, functional impairment and changes in health-related quality of life of patients after COVID-19 critical illness at 6 months....
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2021
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oai:doaj.org-article:9544bd9b6b494ee0a4c91d15b21829162021-11-14T12:06:00ZThe impact of COVID-19 critical illness on new disability, functional outcomes and return to work at 6 months: a prospective cohort study10.1186/s13054-021-03794-01364-8535https://doaj.org/article/9544bd9b6b494ee0a4c91d15b21829162021-11-01T00:00:00Zhttps://doi.org/10.1186/s13054-021-03794-0https://doaj.org/toc/1364-8535Abstract Background There are few reports of new functional impairment following critical illness from COVID-19. We aimed to describe the incidence of death or new disability, functional impairment and changes in health-related quality of life of patients after COVID-19 critical illness at 6 months. Methods In a nationally representative, multicenter, prospective cohort study of COVID-19 critical illness, we determined the prevalence of death or new disability at 6 months, the primary outcome. We measured mortality, new disability and return to work with changes in the World Health Organization Disability Assessment Schedule 2.0 12L (WHODAS) and health status with the EQ5D-5LTM. Results Of 274 eligible patients, 212 were enrolled from 30 hospitals. The median age was 61 (51–70) years, and 124 (58.5%) patients were male. At 6 months, 43/160 (26.9%) patients died and 42/108 (38.9%) responding survivors reported new disability. Compared to pre-illness, the WHODAS percentage score worsened (mean difference (MD), 10.40% [95% CI 7.06–13.77]; p < 0.001). Thirteen (11.4%) survivors had not returned to work due to poor health. There was a decrease in the EQ-5D-5LTM utility score (MD, − 0.19 [− 0.28 to − 0.10]; p < 0.001). At 6 months, 82 of 115 (71.3%) patients reported persistent symptoms. The independent predictors of death or new disability were higher severity of illness and increased frailty. Conclusions At six months after COVID-19 critical illness, death and new disability was substantial. Over a third of survivors had new disability, which was widespread across all areas of functioning. Clinical trial registration NCT04401254 May 26, 2020.Carol L. HodgsonAlisa M. HigginsMichael J. BaileyAnne M. MatherLisa BeachRinaldo BellomoBernie BissettIanthe J. BodenScott BradleyAidan BurrellD. James CooperBentley J. FulcherKimberley J. HainesJack HopkinsAlice Y. M. JonesStuart LaneDrew LawrenceLisa van der LeeJennifer LiacosNatalie J. LinkeLonni Marques GomesMarc NickelsGeorge NtoumenopoulosPaul S. MylesShane PatmanMichelle PatonGemma PoundSumeet RaiAlana RixThomas C. RollinsonJanani SivasuthanClaire J. TippingPeter ThomasTony TrapaniAndrew A. UdyChristina WhiteheadIsabelle T. HodgsonShannah AndersonAry Serpa NetoThe COVID-Recovery Study Investigators and the ANZICS Clinical Trials GroupBMCarticleIntensive careDisabilityCOVID-19Mechanical ventilationLong-term outcomeMedical emergencies. Critical care. Intensive care. First aidRC86-88.9ENCritical Care, Vol 25, Iss 1, Pp 1-12 (2021) |
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DOAJ |
| collection |
DOAJ |
| language |
EN |
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Intensive care Disability COVID-19 Mechanical ventilation Long-term outcome Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 |
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Intensive care Disability COVID-19 Mechanical ventilation Long-term outcome Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Carol L. Hodgson Alisa M. Higgins Michael J. Bailey Anne M. Mather Lisa Beach Rinaldo Bellomo Bernie Bissett Ianthe J. Boden Scott Bradley Aidan Burrell D. James Cooper Bentley J. Fulcher Kimberley J. Haines Jack Hopkins Alice Y. M. Jones Stuart Lane Drew Lawrence Lisa van der Lee Jennifer Liacos Natalie J. Linke Lonni Marques Gomes Marc Nickels George Ntoumenopoulos Paul S. Myles Shane Patman Michelle Paton Gemma Pound Sumeet Rai Alana Rix Thomas C. Rollinson Janani Sivasuthan Claire J. Tipping Peter Thomas Tony Trapani Andrew A. Udy Christina Whitehead Isabelle T. Hodgson Shannah Anderson Ary Serpa Neto The COVID-Recovery Study Investigators and the ANZICS Clinical Trials Group The impact of COVID-19 critical illness on new disability, functional outcomes and return to work at 6 months: a prospective cohort study |
| description |
Abstract Background There are few reports of new functional impairment following critical illness from COVID-19. We aimed to describe the incidence of death or new disability, functional impairment and changes in health-related quality of life of patients after COVID-19 critical illness at 6 months. Methods In a nationally representative, multicenter, prospective cohort study of COVID-19 critical illness, we determined the prevalence of death or new disability at 6 months, the primary outcome. We measured mortality, new disability and return to work with changes in the World Health Organization Disability Assessment Schedule 2.0 12L (WHODAS) and health status with the EQ5D-5LTM. Results Of 274 eligible patients, 212 were enrolled from 30 hospitals. The median age was 61 (51–70) years, and 124 (58.5%) patients were male. At 6 months, 43/160 (26.9%) patients died and 42/108 (38.9%) responding survivors reported new disability. Compared to pre-illness, the WHODAS percentage score worsened (mean difference (MD), 10.40% [95% CI 7.06–13.77]; p < 0.001). Thirteen (11.4%) survivors had not returned to work due to poor health. There was a decrease in the EQ-5D-5LTM utility score (MD, − 0.19 [− 0.28 to − 0.10]; p < 0.001). At 6 months, 82 of 115 (71.3%) patients reported persistent symptoms. The independent predictors of death or new disability were higher severity of illness and increased frailty. Conclusions At six months after COVID-19 critical illness, death and new disability was substantial. Over a third of survivors had new disability, which was widespread across all areas of functioning. Clinical trial registration NCT04401254 May 26, 2020. |
| format |
article |
| author |
Carol L. Hodgson Alisa M. Higgins Michael J. Bailey Anne M. Mather Lisa Beach Rinaldo Bellomo Bernie Bissett Ianthe J. Boden Scott Bradley Aidan Burrell D. James Cooper Bentley J. Fulcher Kimberley J. Haines Jack Hopkins Alice Y. M. Jones Stuart Lane Drew Lawrence Lisa van der Lee Jennifer Liacos Natalie J. Linke Lonni Marques Gomes Marc Nickels George Ntoumenopoulos Paul S. Myles Shane Patman Michelle Paton Gemma Pound Sumeet Rai Alana Rix Thomas C. Rollinson Janani Sivasuthan Claire J. Tipping Peter Thomas Tony Trapani Andrew A. Udy Christina Whitehead Isabelle T. Hodgson Shannah Anderson Ary Serpa Neto The COVID-Recovery Study Investigators and the ANZICS Clinical Trials Group |
| author_facet |
Carol L. Hodgson Alisa M. Higgins Michael J. Bailey Anne M. Mather Lisa Beach Rinaldo Bellomo Bernie Bissett Ianthe J. Boden Scott Bradley Aidan Burrell D. James Cooper Bentley J. Fulcher Kimberley J. Haines Jack Hopkins Alice Y. M. Jones Stuart Lane Drew Lawrence Lisa van der Lee Jennifer Liacos Natalie J. Linke Lonni Marques Gomes Marc Nickels George Ntoumenopoulos Paul S. Myles Shane Patman Michelle Paton Gemma Pound Sumeet Rai Alana Rix Thomas C. Rollinson Janani Sivasuthan Claire J. Tipping Peter Thomas Tony Trapani Andrew A. Udy Christina Whitehead Isabelle T. Hodgson Shannah Anderson Ary Serpa Neto The COVID-Recovery Study Investigators and the ANZICS Clinical Trials Group |
| author_sort |
Carol L. Hodgson |
| title |
The impact of COVID-19 critical illness on new disability, functional outcomes and return to work at 6 months: a prospective cohort study |
| title_short |
The impact of COVID-19 critical illness on new disability, functional outcomes and return to work at 6 months: a prospective cohort study |
| title_full |
The impact of COVID-19 critical illness on new disability, functional outcomes and return to work at 6 months: a prospective cohort study |
| title_fullStr |
The impact of COVID-19 critical illness on new disability, functional outcomes and return to work at 6 months: a prospective cohort study |
| title_full_unstemmed |
The impact of COVID-19 critical illness on new disability, functional outcomes and return to work at 6 months: a prospective cohort study |
| title_sort |
impact of covid-19 critical illness on new disability, functional outcomes and return to work at 6 months: a prospective cohort study |
| publisher |
BMC |
| publishDate |
2021 |
| url |
https://doaj.org/article/9544bd9b6b494ee0a4c91d15b2182916 |
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