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

Citation

Hodgson, CL and Higgins, AM and Bailey, MJ and Mather, AM and Beach, L and Bellomo, R and Bissett, B and Boden, IJ and Bradley, S and Burrell, A and Cooper, DJ and Fulcher, BJ and Haines, KJ and Hopkins, J and Jones, AYM and Lane, S and Lawrence, D and van der Lee, L and Liacos, J and Linke, NJ and Marques Gomes, L and Nickels, M and Ntoumenopoulos, G and Myles, PS and Patman, S and Paton, M and Pound, G and Rai, S and Rix, A and Rollinson, TC and Sivasuthan, J and Tipping, CJ and Thomas, P and Tapani, T and Udy, AA and Whitehead, C and Hodgson, IT and Anderson, S and Neto, AS, COVID-Recovery Study Investigators and the ANZICS Clinical Trials Group, The impact of COVID-19 critical illness on new disability, functional outcomes and return to work at 6 months: a prospective cohort study, Critical Care, 25 Article 382. ISSN 1364-8535 (2021) [Refereed Article]


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Copyright 2021 The Authors Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0) https://creativecommons.org/licenses/by/4.0/

DOI: doi:10.1186/s13054-021-03794-0

Abstract

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-5LTM.

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-5LTM 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.

Item Details

Item Type:Refereed Article
Keywords:intensive care, disability, COVID-19, mechanical ventilation, long-term outcome
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Intensive care
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Boden, IJ (Dr Ianthe Boden)
ID Code:149500
Year Published:2021
Web of Science® Times Cited:6
Deposited By:Health Sciences
Deposited On:2022-04-01
Last Modified:2022-05-06
Downloads:3 View Download Statistics

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