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Long-term recovery in critically ill COVID-19 survivors : A prospective cohort study

Didriksson, Ingrid LU orcid ; Frigyesi, Attila LU ; Spångfors, Martin LU orcid ; Leffler, Märta LU orcid ; Reepalu, Anton LU orcid ; Nilsson, Anna C. LU ; Annborn, Martin LU ; Lybeck, Anna LU orcid ; Friberg, Hans LU and Lilja, Gisela LU (2025) In Acta Anaesthesiologica Scandinavica 69(1).
Abstract

Background: Long-term recovery following critical COVID-19 has not been sufficiently studied. Objective: The primary objective was to describe changes in functional outcome and Health-Related Quality of Life (HRQoL) between 3 and 12 months in critically ill COVID-19 survivors. The secondary objective was to investigate factors associated with good functional outcome and HRQoL at 12 months. Methods: Prospective multicentre cohort study including critically ill COVID-19 patients admitted to six intensive care units in Sweden between May 2020 and May 2021. Surviving patients were invited to face-to-face follow-ups at 3 and 12 months. Functional outcome was assessed using the Glasgow Outcome Scale Extended (GOSE), ranging from 1 to 8.... (More)

Background: Long-term recovery following critical COVID-19 has not been sufficiently studied. Objective: The primary objective was to describe changes in functional outcome and Health-Related Quality of Life (HRQoL) between 3 and 12 months in critically ill COVID-19 survivors. The secondary objective was to investigate factors associated with good functional outcome and HRQoL at 12 months. Methods: Prospective multicentre cohort study including critically ill COVID-19 patients admitted to six intensive care units in Sweden between May 2020 and May 2021. Surviving patients were invited to face-to-face follow-ups at 3 and 12 months. Functional outcome was assessed using the Glasgow Outcome Scale Extended (GOSE), ranging from 1 to 8. Physical and mental HRQoL was assessed by the physical component summary (PCS) and mental component summary (MCS) scores of the Short form health survey version 2 (SF-36v2®). Multivariable logistic regression models were used to identify factors associated with good functional outcome (GOSE ≥7) and good physical and mental HRQoL (PCS and MCS ≥45) at 12 months. Results: The percentage of participants with a good functional outcome increased from 35% to 64% between 3 and 12 months (p <.001). Mean PCS improved from 40 to 44 between 3 and 12 months (p <.001), while the mean MCS was within the normal range at 3 months, with no change at 12 months (46 vs. 48, p =.05). Increasing age was associated with a good functional outcome. Lower clinical frailty and absence of diabetes mellitus were associated with a good PCS. A shorter duration of mechanical ventilation was associated with a good outcome for all three outcome measures. Conclusion: Survivors of critical COVID-19 showed improved functional outcome and physical HRQoL from 3 to 12 months post-ICU. A shorter duration of mechanical ventilation is associated with good functional outcome and good HRQoL, while older age is associated with good functional outcome. Younger patients and those with comorbidities or higher frailty may require targeted follow-up and rehabilitation. Study registration ClinicalTrials.gov Identifier: NCT04974775, registered April 28, 2020.

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; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
COVID-19, Glasgow outcome scale-extended, health-related quality of life, post-COVID-19 condition, post-intensive care syndrome
in
Acta Anaesthesiologica Scandinavica
volume
69
issue
1
article number
e14550
publisher
Blackwell Munksgaard
external identifiers
  • pmid:39540322
  • scopus:85209148868
ISSN
0001-5172
DOI
10.1111/aas.14550
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2024 The Author(s). Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.
id
9c4cdb71-da99-4306-a2a1-dc9d268f36cb
date added to LUP
2024-11-30 19:06:16
date last changed
2025-06-15 10:23:42
@article{9c4cdb71-da99-4306-a2a1-dc9d268f36cb,
  abstract     = {{<p>Background: Long-term recovery following critical COVID-19 has not been sufficiently studied. Objective: The primary objective was to describe changes in functional outcome and Health-Related Quality of Life (HRQoL) between 3 and 12 months in critically ill COVID-19 survivors. The secondary objective was to investigate factors associated with good functional outcome and HRQoL at 12 months. Methods: Prospective multicentre cohort study including critically ill COVID-19 patients admitted to six intensive care units in Sweden between May 2020 and May 2021. Surviving patients were invited to face-to-face follow-ups at 3 and 12 months. Functional outcome was assessed using the Glasgow Outcome Scale Extended (GOSE), ranging from 1 to 8. Physical and mental HRQoL was assessed by the physical component summary (PCS) and mental component summary (MCS) scores of the Short form health survey version 2 (SF-36v2®). Multivariable logistic regression models were used to identify factors associated with good functional outcome (GOSE ≥7) and good physical and mental HRQoL (PCS and MCS ≥45) at 12 months. Results: The percentage of participants with a good functional outcome increased from 35% to 64% between 3 and 12 months (p &lt;.001). Mean PCS improved from 40 to 44 between 3 and 12 months (p &lt;.001), while the mean MCS was within the normal range at 3 months, with no change at 12 months (46 vs. 48, p =.05). Increasing age was associated with a good functional outcome. Lower clinical frailty and absence of diabetes mellitus were associated with a good PCS. A shorter duration of mechanical ventilation was associated with a good outcome for all three outcome measures. Conclusion: Survivors of critical COVID-19 showed improved functional outcome and physical HRQoL from 3 to 12 months post-ICU. A shorter duration of mechanical ventilation is associated with good functional outcome and good HRQoL, while older age is associated with good functional outcome. Younger patients and those with comorbidities or higher frailty may require targeted follow-up and rehabilitation. Study registration ClinicalTrials.gov Identifier: NCT04974775, registered April 28, 2020.</p>}},
  author       = {{Didriksson, Ingrid and Frigyesi, Attila and Spångfors, Martin and Leffler, Märta and Reepalu, Anton and Nilsson, Anna C. and Annborn, Martin and Lybeck, Anna and Friberg, Hans and Lilja, Gisela}},
  issn         = {{0001-5172}},
  keywords     = {{COVID-19; Glasgow outcome scale-extended; health-related quality of life; post-COVID-19 condition; post-intensive care syndrome}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{Blackwell Munksgaard}},
  series       = {{Acta Anaesthesiologica Scandinavica}},
  title        = {{Long-term recovery in critically ill COVID-19 survivors : A prospective cohort study}},
  url          = {{http://dx.doi.org/10.1111/aas.14550}},
  doi          = {{10.1111/aas.14550}},
  volume       = {{69}},
  year         = {{2025}},
}