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Post-Intensive Care Syndrome in COVID-19 Patients in Spanish ICUs. One-Year Follow-Up. CoronaPICS Study
Ángela Alonso-Ovies1,2,3,4, María Ángeles de la Torre Ramos1,3, Carlos Velayos Amo1,2,3
1Servicio de Medicina Intensiva, Hospital Universitario de Fuenlabrada, Madrid, Spain.
Abstract:
PurposeTo characterize post-intensive care syndrome (PICS) in critical patients who survived COVID-19 during the first pandemic wave and to follow PICS symptoms during one year.Material and methodsProspective, observational, multicenter cohort study conducted in 11 Spanish ICUs. Critically ill adult patients who survived SARS-CoV-2 infection and met risk criteria for PICS were included. In-person follow-up was conducted at 3, 6, and 12 months after hospital discharge, assessing physical, cognitive, psychological, and nutritional aspects, quality of life and return to daily activities.ResultsA total of 227 patients were included, of which 120 (52.9%) completed the 3 follow-up visits. Hand dynamometry showed muscle weakness in 40.9% of patients at 3 months, with improvement over time. Anxiety, depression, post-traumatic stress disorder (PTSD) and cognitive impairment were observed in 32.9%, 24.3%, 13.8% and 46.1% of patients, respectively, at 3 months. While anxiety, depression and cognitive impairment slightly decreased over time, PTSD did not. Nutritional risk was significant at 3 months (42.4%), with gradually recovering (3.9% at 1 year). Patients' autonomy, and perception of physical and mental quality of life, improved over the months. At 3 months, 35% of patients had returned to work, and 58.3% at one year. A significant percentage of patients required assistance from physical therapy and mental health professionals after discharge.ConclusionSignificant impairment was observed in all areas of PICS in critically ill patients with COVID-19, with progressive improvement over one year of follow-up, with the adoption of physical, mental, cognitive, and nutritional support measures.
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