Hermann Martina, Filipsky Rebecca, Bukowski Nils, Gerger Gernot, Hermann Alexander, Krenn Katharina, Teufel Anna, Kimberger Oliver, Laxar Daniel, Maleczek Mathias, Schaden Eva, Wiegele Marion, Willschke Harald, Tiboldi Akos
Department of Anaesthesia, Clinical Division of General Anaesthesia and Intensive Care Medicine, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, 1090 Vienna, Austria.
Ludwig Boltzmann Institute Digital Health and Patient Safety, 1180 Vienna, Austria.
J Clin Med. 2025 May 12;14(10):3358. doi: 10.3390/jcm14103358.
Patients suffering from severe COVID-19 often develop acute respiratory distress syndrome (ARDS), necessitating intensive care unit (ICU) and extracorporeal membrane oxygenation (ECMO). Survivors frequently experience negative impacts on their health-related quality of life. These individuals may experience a range of symptoms and may require extended hospitalization and rehabilitation. The objective of this prospective cohort study was to assess the long-term health-related quality of life in intensive care survivors of COVID-19-related ARDS who received ECMO therapy, >18 months after their ICU discharge. The health-related quality of life of COVID-19 survivors who had received extracorporeal membrane oxygenation was evaluated using an augmented version of the Short-Form Health Survey-36, >18 months after their ICU discharge. The outcomes were compared to preexisting data from a meta-analysis analyzing patients with non-COVID-19 ARDS and ECMO therapy. Of the 43 eligible patients (mean age 52 ± 9.5 years), 18 patients (46.2%) responded to the written invitation and were included in this study. The four subscales of the Short-Form Health Survey-36 survey, performed via telephone interview, that showed the most severe limitations (points) were role limitation due to physical problems (37.5), emotional problems (47.9), social functioning (38.1), and general health (49.2). The general health, energy/fatigue (vitality), and physical functioning significantly correlated with higher age ( = 0.004, = 0.003, and = 0.05, respectively). A longer duration of extracorporeal membrane oxygenation was positively associated with an improved energy/fatigue ratio (vitality) and emotional well-being ( = 0.04 and = 0.02, respectively). Compared to survivors of non-COVID-19 ARDS treated with ECMO, the survivors in our cohort scored significantly lower on social functioning, physical functioning, and general health ( < 0.01, = 0.02, < 0.01). Patients who have recovered from intensive care treatment for COVID-19-related ARDS and have received ECMO therapy continue to experience more severe impairments in their physical, mental, and cognitive health-related quality of life. A longer ECMO duration may improve outcomes in this selected patient population.
患有严重新型冠状病毒肺炎（COVID-19）的患者常发展为急性呼吸窘迫综合征（ARDS），需要入住重症监护病房（ICU）并接受体外膜肺氧合（ECMO）治疗。幸存者的健康相关生活质量常常受到负面影响。这些个体可能会出现一系列症状，可能需要延长住院时间和进行康复治疗。这项前瞻性队列研究的目的是评估在ICU出院超过18个月后，接受ECMO治疗的COVID-19相关ARDS重症监护幸存者的长期健康相关生活质量。在ICU出院超过18个月后，使用简短健康调查问卷-36（Short-Form Health Survey-36，SF-36）的增强版对接受体外膜肺氧合治疗的COVID-19幸存者的健康相关生活质量进行评估。将结果与一项分析非COVID-19 ARDS患者和ECMO治疗的荟萃分析中的现有数据进行比较。在43名符合条件的患者（平均年龄52±9.5岁）中，18名患者（46.2%）回复了书面邀请并被纳入本研究。通过电话访谈进行的简短健康调查问卷-36调查的四个分量表中，显示出最严重限制（得分）的是由于身体问题导致的角色限制（37.5）、情绪问题（47.9）、社会功能（38.1）和总体健康（49.2）。总体健康、精力/疲劳（活力）和身体功能与较高年龄显著相关（分别为P = 0.004、P = 0.003和P = 0.05）。体外膜肺氧合的持续时间较长与精力/疲劳比（活力）和情绪健康的改善呈正相关（分别为P = 0.04和P = 0.02）。与接受ECMO治疗的非COVID-19 ARDS幸存者相比，我们队列中的幸存者在社会功能、身体功能和总体健康方面得分显著更低（P < 0.01、P = 0.02、P < 0.01）。从COVID-19相关ARDS的重症监护治疗中康复并接受ECMO治疗的患者在身体、心理和认知健康相关生活质量方面继续经历更严重的损害。较长的ECMO持续时间可能会改善这一特定患者群体中的结果。
