75% of COVID ICU survivors have physical symptoms 1 year on

One year after 246 COVID-19 survivors were treated in 1 of 11 intensive care units (ICUs) in the Netherlands, nearly 75% reported lingering physical symptoms, more than 26% said they had mental symptoms, and upwards of 16% still had cognitive symptoms, according to a study yesterday in JAMA.

The prospective study was conducted among 246 patients 16 years and older admitted to an ICU from Mar 1 to Jul 1, 2020, and followed up to Jun 16, 2021. Average participant age was 61.2 years, 71.5% were men, average body mass index was 28.0 kg/m2 (overweight), and average ICU stay was 18.5 days.

The research team surveyed participants about physical symptoms using the Clinical Frailty Scale, fatigue using the Checklist Individual Strength, mental symptoms using the Hospital Anxiety and Depression Scale, posttraumatic stress disorder (PTSD) using the Impact of Event Scale, and cognitive symptoms using the Cognitive Failures Questionnaire-14 (score of 43 and up indicating cognitive symptoms).

The results are part of the ongoing MONITOR-IC study, which is following recovered COVID-19 patients up to 5 years after they were admitted to an ICU. The research is being led by Radboud University Medical Center researchers in Nijmegen, the Netherlands.

Almost 60% had work-related problems

One year after ICU release, 74.3% of respondents reported physical symptoms, while 26.2% reported mental symptoms (anxiety, 17.9%; depression, 18.3%; PTSD, 9.8%), and 16.2% said they had cognitive symptoms (39 people had scores of 43 or higher).

The most commonly reported new physical problems were weakness (38.9%), joint stiffness (26.3%), joint pain (25.5%), muscle weakness (24.8%), muscle pain (21.3%), and shortness of breath (20.8%).

Among all survivors, 30.6% reported symptoms in at least two domains, while 10.5% reported symptoms in all three domains (physical, mental, and cognitive). Also, 57.8% of survivors who were employed before ICU admission said they had work-related problems (eg, working fewer hours than before, still on sick leave, had left their job).

The study authors said that the long-term consequences of COVID-19 in critically ill patients are still largely unknown but are likely substantial given the known risk factors for post-ICU problems, circumstances of the pandemic, and the rates of symptoms in hospitalized non-ICU COVID-19 patients.

"This study shows what an incredible impact an ICU admission has on the lives of former COVID-19 patients," senior author Marieke Zegers, PhD, said in a Radboud University Medical Center news release. "Even after one year, half of them is [sic] tired or experience lack of the energy to fully resume their work."

The study findings confirm the need for long-term follow-up of these patients, the researchers said. "Insight into the long-term outcomes among patients with COVID-19 who received ICU treatment is important for providing adequate care and aftercare tailored to the clinical needs of these patients," they wrote.

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