Examining recovery trajectories of physical function, activity performance, cognitive and psychological functions, and health related quality of life in COVID-19 patients treated in ICU: a Swedish prospective cohort study

Purpose: To investigate the recovery trajectories of physical function, activity performance, cognitive and psychological functions, and health related quality of life, as well as potential interaction effects, in individuals with COVID-19 treated in an intensive care unit (ICU). Methods: This prospective cohort study included patients with confirmed COVID-19 infection, treated in an ICU. Clinical assessments and self-ratings of functioning, disability and health were performed > 1 month and > 12 months after discharge from hospital. Results: Among the 65 included individuals (mean age 56.6, SD 11) significant improvements in physical and psychological function were observed over time, although not reaching population norms. Cognition remained unchanged (MoCA median 27, IQR 4). At the 12-month follow-up, physical limitations in activity (RAND-36) were found to be associated with dyspnea (mMRC-Dyspnea), mental and physical fatigue (MFI-20), and walking endurance (6-minute walk test) (r2 0.509 p < 0.001). Role limitations due to physical health (RAND-36) was found to be associated with physical and mental fatigue (MFI-20) and pain (r2 0.530 p < 0.001). Conclusion: Despite improvements in functioning and health in this group of predominantly younger age recovery did not reach population norms. These results highlight persistent impairments and activity limitations that may necessitate long-term healthcare interventions.