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Many patients experience long-term negative physical, mental, or cognitive effects after an intensive care unit (ICU) admission. We are just beginning to understand these consequences among the incredible number of patients who have required ICU care for COVID-19.
Dutch investigators studied 246 patients (mean age, 61) who had been admitted to ICUs 1 year earlier for COVID-19 care. Median ICU length of stay was 18.5 days. Almost all patients had been supported with invasive mechanical ventilation. Patients completed several validated surveys about persistent physical, mental, and cognitive symptoms.
Physical symptoms were very common, with more than half of patients reporting persistent fatigue. Other frequently described symptoms included joint stiffness and pain, muscle weakness, and dyspnea. About one quarter of patients reported persistent mental symptoms, with anxiety and depression each reported by ≈18% of respondents. About 16% of patients reported cognitive symptoms. Nearly one third of patients had ongoing symptoms in at least two domains, and more than half had work-related problems.
Heesakkers H et al. Clinical outcomes among patients with 1-year survival following intensive care unit treatment for COVID-19. JAMA 2022 Feb 8; 327:559. (https://doi.org/10.1001/jama.2022.0040)
Comment
The data for patients with COVID-19 are similar to those from earlier studies of patients who were recovering from critical illness. What is unique is the sheer number of patients, after 2 years of the pandemic, who will be navigating these effects. It is essential that outpatient providers ask about persistent symptoms and provide support (e.g., physical therapy, mental health resources) as needed.