Prevalence and Persistence of Post-COVID-19 Condition After Critical Care: 32-Month Follow-Up

Background/Objectives: Post-COVID-19 condition (PCC) remains poorly characterized beyond two years, particularly among intensive care unit (ICU) survivors. We aimed to describe the prevalence, persistence, and late consequences of PCC up to 32 months after discharge in an ICU cohort. Methods: This single-center longitudinal cohort included 170 adults with confirmed SARS-CoV-2 infection admitted to an ICU in Cáceres (Spain) between March 2020 and March 2021. 94 survivors entered follow-up at discharge and 3, 6, 12, 18, 24, and 32 months. PCC manifestations were grouped into five organ system domains (respiratory, cardiovascular, renal, infectious, and musculoskeletal/neuromuscular) and recorded only when supported by clinician-confirmed diagnoses or diagnostic tests. Prevalence at each visit, persistence, and new onset of manifestations between 3 and 6 months, and the cumulative incidence of new chronic diseases between 18 and 32 months were estimated with 95% confidence intervals. Results: Any PCC manifestation was almost universal at discharge (96.8% [95% CI, 91.1-98.9]) and remained high at 12 months (85.2% [95% CI, 76.3-91.2]), declining to 48.6% at 24 months and 25.7% at 32 months. Respiratory manifestations predominated early and were largely resolved by 32 months, whereas musculoskeletal/neuromuscular involvement remained relatively stable. From 18 to 32 months, 36.5% (95% CI, 26.4-47.9) of survivors developed at least one chronic condition, most frequently cardiovascular disease (14.9% [95% CI, 8.5-24.7]). Conclusions: Long-term PCC manifestations and incident chronic diseases are common among ICU COVID-19 survivors, underscoring the need for prolonged follow-up and post-ICU care.