Prevalence of post-intensive care syndrome in mechanically ventilated patients with COVID-19
Por:
Nanwani-Nanwani, K, Lopez-Perez, L, Gimenez-Esparza, C, Ruiz-Barranco, I, Carrillo, E, Arellano, M, Diaz-Diaz, D, Hurtado, B, Garcia-Munoz, A, Relucio, M, Quintana-Diaz, M, Urbez, M, Saravia, A, Bonan, M, Garcia-Rio, F, Testillano, M, Villar, J, de Lorenzo, A and Anon, J
Publicada:
13 may 2022
Categoría:
Multidisciplinary
Resumen:
Coronavirus disease 19 (COVID-19) patients usually require long periods of mechanical ventilation and sedation, which added to steroid therapy, favours a predisposition to the development of delirium and subsequent mental health disorders, as well as physical and respiratory sequelae. The aim of this study was to determine the prevalence of post-intensive care syndrome (PICS) at 3 months after hospital discharge, in a cohort of mechanically ventilated patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). An ambispective, observational study was conducted in three hospitals with intensive care unit (ICU) follow-up clinics. We studied adults who survived a critical illness due to SARS-CoV-2 infection requiring invasive mechanical ventilation. A physical (muscle strength and pulmonary function), functional [12-Item Short Form Health Survey (SF-12), and Barthel score], psychological [hospital anxiety and depression (HADS) and posttraumatic stress disorder symptom severity scales], and cognitive [Montreal cognitive assessment (MoCA) test] assessment were performed. A total of 186 patients were evaluated at 88 days (IQR 68-121) after hospital discharge. Mean age was 59 +/- 12 years old, 126 (68%) patients were men, and median length of mechanical ventilation was 14 days (IQR 8-31). About 3 out of 4 patients (n = 139, 75%) met PICS criteria. Symptoms of cognitive and psychiatric disorders were found in 59 (32%) and 58 (31%) patients, respectively. Ninety-one (49%) patients had muscle weakness. Pulmonary function tests in patients with no respiratory comorbidities showed a normal pattern in 93 (50%) patients, and a restrictive disorder in 62 (33%) patients. Also, 69 patients (37%) were on sick leave, while 32 (17%) had resumed work at the time of assessment. In conclusion, survivors of critical illness due to SARS-CoV-2 infection requiring mechanical ventilation have a high prevalence of PICS. Physical domain is the most frequently damaged, followed by cognitive and psychiatric disorders. ICU follow-up clinics enable the assistance of this vulnerable population.
Filiaciones:
Nanwani-Nanwani, K:
Hosp Univ La Paz, Intens Care Unit, Paseo Castellana 261, Madrid 28046, Spain
Lopez-Perez, L:
Hosp Univ Infanta Leonor, Intens Care Unit, Madrid, Spain
:
Hosp Vega Baja, Intens Care Unit, Alicante, Spain
Ruiz-Barranco, I:
Hosp Univ La Paz, Intens Care Unit, Paseo Castellana 261, Madrid 28046, Spain
Carrillo, E:
Hosp Univ La Paz, Intens Care Unit, Paseo Castellana 261, Madrid 28046, Spain
Arellano, M:
Hosp Univ La Paz, Intens Care Unit, Paseo Castellana 261, Madrid 28046, Spain
Diaz-Diaz, D:
Hosp Univ Infanta Leonor, Intens Care Unit, Madrid, Spain
:
Hosp Vega Baja, Intens Care Unit, Alicante, Spain
Garcia-Munoz, A:
Hosp Univ La Paz, Intens Care Unit, Paseo Castellana 261, Madrid 28046, Spain
:
Hosp Vega Baja, Intens Care Unit, Alicante, Spain
Quintana-Diaz, M:
Hosp Univ La Paz, Intens Care Unit, Paseo Castellana 261, Madrid 28046, Spain
Inst Invest Sanitaria Hosp Univ La Paz IdiPAZ, Madrid, Spain
Univ Autonoma Madrid, Madrid, Spain
Urbez, M:
Hosp Univ La Paz, Dept Phys Med & Rehabil, Madrid, Spain
Saravia, A:
Hosp Univ La Paz, Intens Care Unit, Paseo Castellana 261, Madrid 28046, Spain
Bonan, M:
Hosp Univ La Paz, Dept Psychiat, Madrid, Spain
Garcia-Rio, F:
Inst Invest Sanitaria Hosp Univ La Paz IdiPAZ, Madrid, Spain
Hosp Univ La Paz, Dept Resp Med, Madrid, Spain
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Resp CIBERES, Madrid, Spain
Testillano, M:
Hosp Univ La Paz, Dept Pharm, Madrid, Spain
Villar, J:
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Resp CIBERES, Madrid, Spain
Hosp Univ Dr Negrin, Res Unit, Las Palmas Gran Canaria, Spain
St Michaels Hosp, Li Ka Shing Knowledge Inst, Toronto, ON, Canada
de Lorenzo, A:
Hosp Univ La Paz, Intens Care Unit, Paseo Castellana 261, Madrid 28046, Spain
Inst Invest Sanitaria Hosp Univ La Paz IdiPAZ, Madrid, Spain
Univ Autonoma Madrid, Madrid, Spain
Anon, J:
Hosp Univ La Paz, Intens Care Unit, Paseo Castellana 261, Madrid 28046, Spain
Inst Invest Sanitaria Hosp Univ La Paz IdiPAZ, Madrid, Spain
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Resp CIBERES, Madrid, Spain
Green Published, gold
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