The impact of COVID-19 critical illness on new disability, functional outcomes and return to work at 6 months: a prospective cohort study

被引：81

作者：

Hodgson, Carol L. ^{[1
,2
,3
,4
]}

Higgins, Alisa M. ^{[1
]}

Bailey, Michael J. ^{[1
,2
]}

Mather, Anne M. ^{[1
]}

Beach, Lisa ^{[5
]}

Bellomo, Rinaldo ^{[1
,4
,25
]}

Bissett, Bernie ^{[6
,7
]}

Boden, Ianthe J. ^{[8
,9
]}

Bradley, Scott ^{[3
]}

Burrell, Aidan ^{[2
]}

Cooper, D. James ^{[1
,2
]}

Fulcher, Bentley J. ^{[1
]}

Haines, Kimberley J. ^{[10
]}

Hopkins, Jack ^{[1
]}

Jones, Alice Y. M. ^{[11
]}

Lane, Stuart ^{[1
,12
]}

Lawrence, Drew ^{[3
]}

van der Lee, Lisa ^{[13
]}

Liacos, Jennifer ^{[3
]}

Linke, Natalie J. ^{[1
]}

Gomes, Lonni Marques ^{[1
]}

Nickels, Marc ^{[14
]}

Ntoumenopoulos, George ^{[15
]}

Myles, Paul S. ^{[16
]}

Patman, Shane ^{[17
]}

Paton, Michelle ^{[1
,18
]}

Pound, Gemma ^{[1
,19
]}

Rai, Sumeet ^{[20
,21
]}

Rix, Alana ^{[3
]}

Rollinson, Thomas C. ^{[22
,23
]}

Sivasuthan, Janani ^{[1
]}

Tipping, Claire J. ^{[3
]}

Thomas, Peter ^{[24
]}

Trapani, Tony ^{[1
]}

Udy, Andrew A. ^{[1
,2
]}

Whitehead, Christina ^{[1
,12
]}

Hodgson, Isabelle T. ^{[1
]}

Anderson, Shannah ^{[1
]}

Neto, Ary Serpa ^{[1
,5
,24
,26
]}

机构：

[1] Monash Univ, Australian & New Zealand Intens Care Res Ctr, Sch Publ Hlth & Prevent Med, Melbourne, Vic, Australia

[2] Alfred, Dept Intens Care & Hyperbar Med, Melbourne, Vic, Australia

[3] Alfred, Dept Physiotherapy, Melbourne, Vic, Australia

[4] Univ Melbourne, Sch Med, Dept Crit Care, Melbourne, Vic, Australia

[5] Royal Melbourne Hosp, Dept Physiotherapy, Allied Hlth, Melbourne, Vic, Australia

[6] Univ Canberra, Discipline Physiotherapy, Canberra, ACT, Australia

[7] Canberra Hosp, Physiotherapy Dept, Canberra, ACT, Australia

[8] Launceston Gen Hosp, Physiotherapy Dept, Launceston, Tas, Australia

[9] Univ Tasmania, Launceston Clin Sch, Hobart, Tas, Australia

[10] Western Hlth, Physiotherapy Dept, Melbourne, Vic, Australia

[11] Univ Queensland, Sch Hlth & Rehabil Sci, Brisbane, Qld, Australia

[12] Intens Care Med Nepean Hosp, Sydney, NSW, Australia

[13] Fiona Stanley Hosp, Perth, WA, Australia

[14] Princess Alexandra Hosp, Physiotherapy Dept, Metro South Hlth, Woolloongabba, Qld, Australia

[15] St Vincents Hosp, Physiotherapy, Sydney, NSW, Australia

[16] Monash Univ, Cent Clin Sch, Dept Anaesthesiol & Perioperat Med, Melbourne, Vic, Australia

[17] Univ Notre Dame Australia, Fac Med Nursing & Midwifery, Hlth Sci & Physiotherapy, Perth, WA, Australia

[18] Monash Hlth, Dept Physiotherapy, Melbourne, Vic, Australia

[19] St Vincents Hosp, Physiotherapy Dept, Melbourne, Vic, Australia

[20] Canberra Hlth Serv, Canberra, ACT, Australia

[21] Australia Natl Univ, Med Sch, Canberra, ACT, Australia

[22] Austin Hlth, Div Allied Hlth, Dept Physiotherapy, Melbourne, Vic, Australia

[23] Univ Melbourne, Dept Physiotherapy, Melbourne, Vic, Australia

[24] Royal Brisbane & Womens Hosp, Dept Physiotherapy, Brisbane, Qld, Australia

[25] Austin Hosp, Data Analyt Res & Evaluat Dare Ctr, Melbourne, Vic, Australia

[26] Hosp Israelita Albert Einstein, Dept Crit Care Med, Sao Paulo, Brazil

来源：

CRITICAL CARE | 2021年 / 25卷 / 01期

基金：

英国医学研究理事会; 澳大利亚国家健康与医学研究理事会;

关键词：

Intensive care; Disability; COVID-19; Mechanical ventilation; Long-term outcome; LONG-TERM OUTCOMES; SURVIVORS; CONSEQUENCES; ASSOCIATION; DISCHARGE; FRAILTY;

D O I：

10.1186/s13054-021-03794-0

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

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-5L (TM). 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-5L (TM) 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.

引用

页数：12

共 38 条

[1] Australian and New Zealand Pulmonary Rehabilitation Guidelines [J].

Alison, Jennifer A. ;

McKeough, Zoe J. ;

Johnston, Kylie ;

McNamara, Renae J. ;

Spencer, Lissa M. ;

Jenkins, Sue C. ;

Hill, Catherine J. ;

McDonald, Vanessa M. ;

Frith, Peter ;

Cafarella, Paul ;

Brooke, Michelle ;

Cameron-Tucker, Helen L. ;

Candy, Sarah ;

Cecins, Nola ;

Chan, Andrew S. L. ;

Dale, Marita T. ;

Dowman, Leona M. ;

Granger, Catherine ;

Halloran, Simon ;

Jung, Peter ;

Lee, Annemarie L. ;

Leung, Regina ;

Matulick, Tamara ;

Osadnik, Christian ;

Roberts, Mary ;

Walsh, James ;

Wootton, Sally ;

Holland, Anne E. .

RESPIROLOGY, 2017, 22 (04) :800-819

[2]

[Anonymous], 2020, LANCET, V396, P1861, DOI 10.1016/S0140-6736(20)32662-3

[3] Long-haul COVID: heed the lessons from other infection-triggered illnesses [J].

Aucott, John N. ;

Rebman, Alison W. .

LANCET, 2021, 397 (10278) :967-968

[4]

Australian Government Department of Health, 2020, InfraPPP reports

[5] Association between frailty and short- and long-term outcomes among critically ill patients: a multicentre prospective cohort study [J].

Bagshaw, Sean M. ;

Stelfox, H. Thomas ;

McDermid, Robert C. ;

Rolfson, Darryl B. ;

Tsuyuki, Ross T. ;

Baig, Nadia ;

Artiuch, Barbara ;

Ibrahim, Quazi ;

Stollery, Daniel E. ;

Rokosh, Ella ;

Majumdar, Sumit R. .

CANADIAN MEDICAL ASSOCIATION JOURNAL, 2014, 186 (02) :E95-E102

[6] Outcomes for patients with COVID-19 admitted to Australian intensive care units during the first four months of the pandemic [J].

Burrell, Aidan J. C. ;

Pellegrini, Breanna ;

Salimi, Farhad ;

Begum, Husna ;

Broadley, Tessa ;

Campbell, Lewis T. ;

Cheng, Allen C. ;

Cheung, Winston ;

Cooper, D. James ;

Earnest, Arul ;

Erickson, Simon J. ;

French, Craig J. ;

Kaldor, John M. ;

Litton, Edward ;

Murthy, Srinivas ;

McAllister, Richard E. ;

Nichol, Alistair D. ;

Palermo, Annamaria ;

Plummer, Mark P. ;

Ramanan, Mahesh ;

Reddi, Benjamin A. J. ;

Reynolds, Claire ;

Trapani, Tony ;

Webb, Steve A. ;

Udy, Andrew A. .

MEDICAL JOURNAL OF AUSTRALIA, 2021, 214 (01) :23-30

[7] Long-term follow-up of recovered patients with COVID-19 Comment [J].

Cortinovis, Monica ;

Perico, Norberto ;

Remuzzi, Giuseppe .

LANCET, 2021, 397 (10270) :173-175

[8] Telerehabilitation for chronic respiratory disease [J].

Cox, Narelle S. ;

Dal Corso, Simone ;

Hansen, Henrik ;

McDonald, Christine F. ;

Hill, Catherine J. ;

Zanaboni, Paolo ;

Alison, Jennifer A. ;

O'Halloran, Paul ;

Macdonald, Heather ;

Holland, Anne E. .

COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2021, (01)

[9] Long-term Health Consequences of COVID-19 [J].

del Rio, Carlos ;

Collins, Lauren F. ;

Malani, Preeti .

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2020, 324 (17) :1723-1724

[10] Long term respiratory complications of covid-19 [J].

Fraser, Emily .

BMJ-BRITISH MEDICAL JOURNAL, 2020, 370

← 1 2 3 4 →