Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy -
Department of Anesthesia, Critical Care and Emergency, ASST Spedali Civili di Brescia, Brescia, Italy -
Minerva Anestesiol. 2022 Jan-Feb;88(1-2):72-79. doi: 10.23736/S0375-9393.21.16032-8. Epub 2021 Oct 28.
Coronavirus disease 2019 (COVID-19) has caused more than 175 million persons infected and 3.8 million deaths so far and is having a devastating impact on both low and high-income countries, in particular on hospitals and Intensive Care Units (ICU). The ICU mortality during the first pandemic wave ranged from 40% to 85% during the busiest ICU period for admissions around the peak of the surge, and those surviving are frequently faced with impairments affecting physical, cognitive, and mental health status, complicating the postacute phase of COVID-19, which in the pre-COVID period, were defined collectively as postintensive care syndrome (PICS). Long COVID is defined as four weeks of persisting symptoms after the acute illness, and post-COVID syndrome and chronic COVID-19 are the proposed terms to describe continued symptomatology for more than 12 weeks. Overall, 50% of ICU survivors suffer from new physical, mental, and/or cognitive problems at 1 year after ICU discharge. The prevalence, severity, and duration of the various impairments in ICU survivors are poorly defined, with substantial variations among published series, and may reflect differences in the timing of assessment, the outcome measured, the instruments utilized, and thresholds adopted to establish the diagnosis, the qualification of personnel delivering the tests, the resource availability as well diversity in patients' case-mix. Future longitudinal studies of adequate sample size with repeated assessments of validated outcomes and comparison with non-COVID-19 ICU patients are needed to fully explore the long-term outcome of ICU patients with COVID-19. In this article, we focus on chronic COVID-19 in ICU survivors and present state-of-the-art data regarding long-term complications related to critical illness and the treatments and organ support received.
新型冠状病毒病（COVID-19）已导致超过 1.75 亿人感染和 380 万人死亡，对中低收入国家，尤其是医院和重症监护病房（ICU）造成了毁灭性的影响。在第一波大流行期间，ICU 死亡率在 ICU 最繁忙的时期，即在高峰期的入院高峰期，最高可达 40%至 85%，而那些幸存下来的患者经常面临影响身体、认知和心理健康状况的损害，使 COVID-19 的急性后期复杂化，在 COVID 之前，这些问题统称为重症监护后综合征（PICS）。长 COVID 定义为急性疾病后持续 4 周的症状，而 COVID 后综合征和慢性 COVID-19 是用于描述超过 12 周持续症状的拟议术语。总体而言，50%的 ICU 幸存者在 ICU 出院后 1 年仍有新的身体、心理和/或认知问题。在 ICU 幸存者中，各种损伤的患病率、严重程度和持续时间定义不明确，在已发表的系列研究中差异很大，可能反映了评估时间、测量的结果、使用的工具以及采用的诊断标准、进行测试的人员的资格、资源可用性以及患者病例组合的多样性的差异。需要进行足够样本量的未来纵向研究，对经过验证的结果进行重复评估，并与非 COVID-19 ICU 患者进行比较，以充分探讨 COVID-19 ICU 患者的长期预后。在本文中，我们重点关注 ICU 幸存者的慢性 COVID-19，并介绍与危重病相关的长期并发症以及所接受的治疗和器官支持的最新数据。
