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Prolonged Fatigue and Mental Health Challenges in Critical COVID-19 Survivors

Hultgren, Malin LU ; Didriksson, Ingrid LU orcid ; Håkansson, Anders LU ; Andertun, Sara LU ; Frigyesi, Attila LU ; Mellerstedt, Erik ; Nelderup, Maria ; Nilsson, Anna C LU ; Reepalu, Anton LU orcid and Spångfors, Martin LU orcid , et al. (2024) In Journal of Intensive Care Medicine
Abstract

Background: The aim of this study was to investigate the development of fatigue and mental illness between 3 and 12 months after critical COVID-19 and explore risk factors for long-lasting symptoms. Study Design and Methods: A prospective, multicenter COVID-19 study in southern Sweden, including adult patients (≥18 years) with rtPCR-confirmed COVID-19 requiring intensive care. Survivors were invited to a follow-up at 3 and 12 months, where patient-reported symptoms were assessed using the Modified Fatigue Impact Scale (MFIS), the Hospital Anxiety and Depression Scale (HADS) and the Posttraumatic Stress Disorder Checklist version 5 (PCL-5). The development between 3 and 12 months was described by changes in relation to statistical... (More)

Background: The aim of this study was to investigate the development of fatigue and mental illness between 3 and 12 months after critical COVID-19 and explore risk factors for long-lasting symptoms. Study Design and Methods: A prospective, multicenter COVID-19 study in southern Sweden, including adult patients (≥18 years) with rtPCR-confirmed COVID-19 requiring intensive care. Survivors were invited to a follow-up at 3 and 12 months, where patient-reported symptoms were assessed using the Modified Fatigue Impact Scale (MFIS), the Hospital Anxiety and Depression Scale (HADS) and the Posttraumatic Stress Disorder Checklist version 5 (PCL-5). The development between 3 and 12 months was described by changes in relation to statistical significance and suggested values for a minimally important difference (MID). Potential risk factors for long-lasting symptoms were analyzed by multivariable logistic regression. Results: At the 3-month follow-up, 262 survivors (87%) participated, 215 (72%) returned at 12 months. Fatigue was reported by 50% versus 40%, with a significant improvement at 12 months (MFIS; median 38 vs. 33, P < .001, MID ≥4). There were no significant differences in symptoms of mental illness between 3 and 12 months, with anxiety present in 33% versus 28%, depression in 30% versus 22%, and posttraumatic stress disorder in 17% versus 13%. A worse functional outcome and less sleep compared to before COVID-19 were risk factors for fatigue and mental illness at 12 months. Conclusions: Fatigue improved between 3 and 12 months but was still common. Symptoms of mental illness remained unchanged with anxiety being the most reported. A worse functional outcome and less sleep compared to before COVID-19 were identified as risk factors for reporting long-lasting symptoms.

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publication status
epub
subject
in
Journal of Intensive Care Medicine
article number
8850666241255328
publisher
SAGE Publications
external identifiers
  • scopus:85199877361
  • pmid:39042144
ISSN
0885-0666
DOI
10.1177/08850666241255328
language
English
LU publication?
yes
id
6190f576-c04b-4ab1-a007-876e29ea9018
date added to LUP
2024-08-03 20:13:43
date last changed
2024-08-05 09:02:24
@article{6190f576-c04b-4ab1-a007-876e29ea9018,
  abstract     = {{<p> Background: The aim of this study was to investigate the development of fatigue and mental illness between 3 and 12 months after critical COVID-19 and explore risk factors for long-lasting symptoms.  Study Design and Methods: A prospective, multicenter COVID-19 study in southern Sweden, including adult patients (≥18 years) with rtPCR-confirmed COVID-19 requiring intensive care. Survivors were invited to a follow-up at 3 and 12 months, where patient-reported symptoms were assessed using the Modified Fatigue Impact Scale (MFIS), the Hospital Anxiety and Depression Scale (HADS) and the Posttraumatic Stress Disorder Checklist version 5 (PCL-5). The development between 3 and 12 months was described by changes in relation to statistical significance and suggested values for a minimally important difference (MID). Potential risk factors for long-lasting symptoms were analyzed by multivariable logistic regression. Results: At the 3-month follow-up, 262 survivors (87%) participated, 215 (72%) returned at 12 months. Fatigue was reported by 50% versus 40%, with a significant improvement at 12 months (MFIS; median 38 vs. 33,  P &lt; .001, MID ≥4). There were no significant differences in symptoms of mental illness between 3 and 12 months, with anxiety present in 33% versus 28%, depression in 30% versus 22%, and posttraumatic stress disorder in 17% versus 13%. A worse functional outcome and less sleep compared to before COVID-19 were risk factors for fatigue and mental illness at 12 months. Conclusions: Fatigue improved between 3 and 12 months but was still common. Symptoms of mental illness remained unchanged with anxiety being the most reported. A worse functional outcome and less sleep compared to before COVID-19 were identified as risk factors for reporting long-lasting symptoms. </p>}},
  author       = {{Hultgren, Malin and Didriksson, Ingrid and Håkansson, Anders and Andertun, Sara and Frigyesi, Attila and Mellerstedt, Erik and Nelderup, Maria and Nilsson, Anna C and Reepalu, Anton and Spångfors, Martin and Friberg, Hans and Lilja, Gisela}},
  issn         = {{0885-0666}},
  language     = {{eng}},
  month        = {{07}},
  publisher    = {{SAGE Publications}},
  series       = {{Journal of Intensive Care Medicine}},
  title        = {{Prolonged Fatigue and Mental Health Challenges in Critical COVID-19 Survivors}},
  url          = {{http://dx.doi.org/10.1177/08850666241255328}},
  doi          = {{10.1177/08850666241255328}},
  year         = {{2024}},
}