Pauley Ellen, Drake Thomas M, Griffith David M, Sigfrid Louise, Lone Nazir I, Harrison Ewen M, Baillie J Kenneth, Scott Janet T, Walsh Timothy S, Semple Malcolm G, Docherty Annemarie B
, Edinburgh, UKUniversity of Edinburgh Medical School.
Centre for Medical Informatics, The Usher Institute, , Edinburgh, UKUniversity of Edinburgh.
J Intensive Care Soc. 2023 May;24(2):162-169. doi: 10.1177/17511437211052226. Epub 2021 Oct 24.
We aimed to compare the prevalence and severity of fatigue in survivors of Covid-19 versus non-Covid-19 critical illness, and to explore potential associations between baseline characteristics and worse recovery.
We conducted a secondary analysis of two prospectively collected datasets. The population included was 92 patients who received invasive mechanical ventilation (IMV) with Covid-19, and 240 patients who received IMV with non-Covid-19 illness before the pandemic. Follow-up data were collected post-hospital discharge using self-reported questionnaires. The main outcome measures were self-reported fatigue severity and the prevalence of severe fatigue (severity >7/10) 3 and 12-months post-hospital discharge.
Covid-19 IMV-patients were significantly younger with less prior comorbidity, and more males, than pre-pandemic IMV-patients. At 3-months, the prevalence (38.9% [7/18] vs. 27.1% [51/188]) and severity (median 5.5/10 vs 5.0/10) of fatigue were similar between the Covid-19 and pre-pandemic populations, respectively. At 6-months, the prevalence (10.3% [3/29] vs. 32.5% [54/166]) and severity (median 2.0/10 vs. 5.7/10) of fatigue were less in the Covid-19 cohort. In the total sample of IMV-patients included (i.e. all Covid-19 and pre-pandemic patients), having Covid-19 was significantly associated with less severe fatigue (severity <7/10) after adjusting for age, sex and prior comorbidity (adjusted OR 0.35 (95%CI 0.15-0.76, =0.01).
Fatigue may be less severe after Covid-19 than after other critical illness.
我们旨在比较新冠病毒病(Covid-19)幸存者与非Covid-19危重症患者疲劳的患病率和严重程度,并探讨基线特征与恢复较差之间的潜在关联。
我们对两个前瞻性收集的数据集进行了二次分析。纳入的人群包括92例接受有创机械通气(IMV)的Covid-19患者,以及240例在疫情大流行前接受IMV的非Covid-19疾病患者。出院后使用自我报告问卷收集随访数据。主要结局指标为自我报告的疲劳严重程度以及出院后3个月和12个月时严重疲劳(严重程度>7/10)的患病率。
与疫情大流行前的IMV患者相比,Covid-19的IMV患者明显更年轻,既往合并症更少,男性更多。在3个月时,Covid-19组和疫情大流行前组的疲劳患病率(分别为38.9%[7/18]对27.1%[51/188])和严重程度(中位数5.5/10对5.0/10)相似。在6个月时,Covid-19队列中的疲劳患病率(10.3%[3/29]对32.5%[54/166])和严重程度(中位数2.0/10对5.7/10)较低。在纳入的IMV患者总样本中(即所有Covid-19和疫情大流行前的患者),在调整年龄、性别和既往合并症后,感染Covid-19与较轻的疲劳严重程度(严重程度<7/10)显著相关(调整后的比值比为0.35(95%置信区间0.15 - 0.76,P = 0.01)。
Covid-19后的疲劳可能比其他危重症后的疲劳程度较轻。