Ersson Anders, Reuterborg Henrik Överengen, Divanoglou Anestis, Levi Richard, Orwelius Lotti
Department of Anesthesia and Intensive Care, Nyköping Hospital, Nyköping, Sweden.
Faculty of Medicine, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
J Patient Rep Outcomes. 2025 May 14;9(1):52. doi: 10.1186/s41687-025-00883-4.
In 2020 as COVID-19 rapidly overwhelmed ICU resources, patient care capacity was reduced thus increasing the risk of development of post intensive care syndrome (PICS). Therefore, an increased incidence of survivors with neurocognitive and neuromuscular impairment could be anticipated. This study aimed to describe residual reductions in health-related quality of life (HRQoL) and risk factors for PICS as they pertain to outcomes one year after intensive care.
Between 01-03-2020 and 31-08-2020, all adult COVID-19 ICU patients discharged alive in two Swedish ICU were included. At 2-, 6- and, 12-months post discharge follow up was conducted. Primary outcome parameters were HRQoL up to 12-months after ICU discharge. Secondary outcome parameters were clinimetric results for physical, mental, and cognitive functions at 6 months after intensive care stay.
Data from 41 patients were analyzed. Fatigue, anxiety, respiratory impairments, and experienced decline in physical stamina were the dominating findings at 6 months. Criteria for PICS were fulfilled in 93% of the study population and a 60% reduction in overall HRQoL, compared with a normal age adjusted population, was seen at follow up. A slight improvement was seen at 6 months whereafter no further significant improvement in HRQoL was detected. Fatigue was the most dominant complaint, expressed by almost all patients at follow up.
Long term outcome reported in this study showed longstanding impairment in HRQoL, mostly related to reduced well-being and perceived limitations in physical ability. Overall, our findings show similarities with previously reported recovery patterns after intensive care. However, the COVID-19 cohort displayed a more profound reduction in HRQoL paralleled with severe fatigue and respiratory limitations. This signals the need for a deeper understanding of pathophysiological mechanisms of COVID-19 induced residual impairments and more precise instruments to tailor an individually designed aftercare.
2020年，随着新型冠状病毒肺炎（COVID-19）迅速压垮重症监护病房（ICU）资源，患者护理能力下降，从而增加了发生重症监护后综合征（PICS）的风险。因此，可以预期神经认知和神经肌肉功能障碍幸存者的发病率会增加。本研究旨在描述与重症监护一年后的结局相关的健康相关生活质量（HRQoL）的残留降低情况以及PICS的危险因素。
纳入2020年3月1日至2020年8月31日期间在瑞典两家ICU存活出院的所有成年COVID-19 ICU患者。在出院后2个月、6个月和12个月进行随访。主要结局参数是ICU出院后长达12个月的HRQoL。次要结局参数是重症监护住院6个月时身体、心理和认知功能的临床测量结果。
分析了41例患者的数据。疲劳、焦虑、呼吸功能障碍以及体力下降是6个月时的主要发现。93%的研究人群符合PICS标准，随访时与正常年龄调整人群相比，总体HRQoL降低了60%。在6个月时观察到略有改善，此后未检测到HRQoL有进一步的显著改善。疲劳是最主要的主诉，几乎所有患者在随访时都有表达。
本研究报告的长期结局显示HRQoL长期受损，主要与幸福感降低和身体能力方面的感知限制有关。总体而言，我们的研究结果与先前报道的重症监护后的恢复模式相似。然而，COVID-19队列的HRQoL下降更为严重，同时伴有严重疲劳和呼吸功能受限。这表明需要更深入地了解COVID-19诱导的残留损伤的病理生理机制，以及更精确的工具来定制个性化的后续护理。
