Post-intensive care syndrome at one month after hospital discharge in critically ill patients surviving COVID-19

Objectives: incidence of post-intensive care syndrome at one month after hospital discharge in surviving critically ill COVID 19 patients and to identify associated factors. Design: prospective cohort study. Setting: two multipurpose critical care units of the Araba University Hospital.Patients admitted to critical care units for severe acute respiratory failure secondary to COVID 19. Intervention: none. Variables of interest: demographic variables, length of stay, Charlson index, APACHE II, SOFA, days of mechanical ventilation, tracheotomy, delirium, tetraparesis of the critical patient, EuroQol 5D5L, Minimental Test. Results: a deterioration in the EuroQol health index (HI) from 90.9 +/- 16.9 to 70.9 +/- 24.7 (p < 0.001) was observed. The impairment of the five EuroQol domains is: mobility (46.1%), usual activities (44.7%), discomfort/pain (30.7%), psychological domain (27.3%) and self-care (20.3%). The 61.5% suffer a significant decrease in their health index. Multivariate analysis by logistic regression shows us that delirium (OR= 3.01; 95%CI: 1.01-8.9; p= 0.047) and tracheostomy (OR= 2.37; 95%CI: 1.09-5.14; p= 0.029) show association with drop in EuroQoL 5D5L SI. The area under the ROC curve of the model is 67.3%, with a confidence interval between 58% and 76%. The model is calibrated using the Hosmer-Lemeshow test:(chi 2=0.468; p=0.792). Only 1.2% of patients showed a score <= 24, clearly pathological, on the Folstein's Minimental Test. Conclusions: delirium and need for tracheostomy are associated with post-intensive care syndrome assessed by EuroQol 5D5L.

Automated summary

The incidence of post-intensive care syndrome is high in COVID-19 patients who have been admitted to the critical care units. Delirium and the need for tracheostomy are associated with the occurrence of post-intensive care syndrome.