Thomas Merlin, Hameed Mansoor, Hussein Mousa, George Saibu, Rajalekshmi M R, Akram Jaweria, Sharma Rohit, Al Adab Aisha Hussain O, Ahmad Mushtaq, Singh Rajvir, Raza Tasleem
Pulmonary Division, Department of Chest, Hamad General Hospital, Doha, Qatar.
Department of Clinical Medicine, Weill Cornell Medicine, Doha, Qatar.
Front Med (Lausanne). 2024 Jul 31;11:1288761. doi: 10.3389/fmed.2024.1288761. eCollection 2024.
The Outcomes - Short and Long term in ICU patient with COVID-19 "OUTSTRIP COVID-19" study was initiated to assess overall mortality, physical and psychiatric co-morbidities, reduction in lung function, and the ability to return to work post-ICU discharge with a follow-up period of 2 years in COVID-19 patients admitted to ICUs in Qatar. This paper focuses on the prevalence of cognitive impairment, depression, anxiety, and stress at baseline and 3 months after ICU discharge.
This prospective cohort study included 100 ICU survivors reviewed at baseline within 7 weeks of ICU discharge, with a 3-month follow-up. Demographics, clinical characteristics, and relevant medical history were collected at baseline. Cognitive outcomes were assessed using the Montreal Cognitive Assessment-Basic (MoCA-B) tool, while psychological outcomes were evaluated using the Depression Anxiety and Stress Scale-21 (DASS-21).
At baseline, 72% of ICU survivors exhibited mild cognitive impairment, which significantly improved to 56% at 3 months. However, severe cognitive impairment persisted in 20% of survivors at 3 months.For psychological outcomes, the mean depression score remained below 9 (5.64 ± 6.90) at both time points, with no significant change. At baseline, 25% of survivors had clinical depression, which reduced to 16% at 3 months.The mean anxiety score at baseline (9.35 ± 8.50) significantly decreased to 6.51 ± 7.74 (p = 0.002) at 3 months. Anxiety was not reported by 48% of survivors at baseline and this increased to 66% at 3 months. Severe to extremely severe anxiety decreased from 19% to 12% during the same period.The mean stress score at baseline (8.34 ± 8.07) did not significantly change at 3 months. At baseline, 18% experienced stress, which decreased to 12% at 3 months, with 5.3% facing severe to extremely severe stress.
COVID-19 ICU survivors experience significant cognitive impairment, anxiety, and stress. While cognitive impairment and anxiety showed improvements at 3 months, depression and stress remained unchanged. These outcomes strongly emphasize the requirement for thorough post-ICU care and comprehensive mental health assistance for individuals recovering from COVID-19. Customized interventions and additional research endeavors are crucial to effectively manage the cognitive and psychological consequences faced by these patients. The exploration of telemonitoring and innovative approaches can offer avenues to enhance the overall quality of life for survivors. Further investigation should encompass extended timeframes to analyze prolonged effects and consider the broader socioeconomic impact.
启动了“COVID-19重症监护病房患者的短期和长期结局——‘超越COVID-19’研究”，以评估卡塔尔重症监护病房收治的COVID-19患者的总体死亡率、身体和精神合并症、肺功能下降情况以及重症监护病房出院后2年的复工能力。本文重点关注基线时以及重症监护病房出院后3个月时认知障碍、抑郁、焦虑和压力的患病率。
这项前瞻性队列研究纳入了100名重症监护病房幸存者，在重症监护病房出院后7周内进行基线评估，并进行3个月的随访。在基线时收集人口统计学、临床特征和相关病史。使用蒙特利尔认知评估基础版（MoCA-B）工具评估认知结局，同时使用抑郁焦虑压力量表21（DASS-21）评估心理结局。
在基线时，72%的重症监护病房幸存者存在轻度认知障碍，3个月时显著改善至56%。然而，3个月时仍有20%的幸存者存在严重认知障碍。对于心理结局，两个时间点的平均抑郁评分均低于9（5.64±6.90），无显著变化。在基线时，25%的幸存者有临床抑郁，3个月时降至16%。基线时的平均焦虑评分为（9.35±8.50），3个月时显著降至6.51±7.74（p = 0.002）。48%的幸存者在基线时未报告焦虑，3个月时这一比例增至66%。同期，严重至极严重焦虑从19%降至12%。基线时的平均压力评分为（8.34±8.07），3个月时无显著变化。在基线时，18%的人经历过压力，3个月时降至12%，5.3%的人面临严重至极严重的压力。
COVID-19重症监护病房幸存者存在显著的认知障碍、焦虑和压力。虽然认知障碍和焦虑在3个月时有所改善，但抑郁和压力保持不变。这些结果强烈强调了对从COVID-19中康复的个体进行全面的重症监护病房后护理和综合心理健康援助的必要性。定制干预措施和更多的研究工作对于有效管理这些患者面临的认知和心理后果至关重要。对远程监测和创新方法的探索可以为提高幸存者的整体生活质量提供途径。进一步的研究应涵盖更长的时间范围，以分析长期影响并考虑更广泛的社会经济影响。
