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Surviving critical COVID-19: How functionality, physical, mental and cognitive outcomes evolve?

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Critical COVID-19 survivors experience persistent physical, mental, and cognitive impairments long after intensive care unit (ICU) discharge. While some recovery is observed, deficits in strength, balance, and daily activities remain significant up to 12 months post-ICU.

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Area of Science:

  • Critical care medicine
  • Infectious diseases
  • Rehabilitation medicine
  • Neuroscience
  • Psychiatry

Background:

  • Critical COVID-19 can lead to long-term health issues, collectively known as post-intensive care syndrome (PICS).
  • Understanding the trajectory of physical, mental, and cognitive impairments is crucial for effective patient management and rehabilitation strategies.

Purpose of the Study:

  • To analyze the long-term physical, mental, cognitive, and functional consequences of critical COVID-19.
  • To describe the evolution of these impairments over time in survivors.

Main Methods:

  • Prospective cohort study of patients admitted to the ICU for SARS-CoV-2 infection.
  • Patients received Physical and Rehabilitation Medicine (PRM) services during ICU stay.
  • Evaluations of physical, mental, and cognitive domains were conducted at 6 and 12 months post-ICU discharge using standardized assessments.

Main Results:

  • Significant impairments in quality of life, muscle strength, gait, and balance were observed at 6 and 12 months post-ICU discharge.
  • Anxiety and depression levels remained elevated, with significant cognitive deficits noted at both follow-up points.
  • Functional autonomy in daily living improved from 54.8% at 6 months to 74.0% at 12 months post-discharge.

Conclusions:

  • Critical COVID-19 survivors exhibit substantial physical, mental, and cognitive impairments up to 12 months after ICU discharge.
  • Despite a positive trend in recovery, significant deficits persist, highlighting the need for ongoing rehabilitation and support.
  • The study underscores the profound and lasting impact of severe COVID-19 on multiple health domains.