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The impact of COVID-19 critical illness on new disability, functional outcomes and return to work at 6 months: a prospective cohort study.
Hodgson, Carol L; Higgins, Alisa M; Bailey, Michael J; Mather, Anne M; Beach, Lisa; Bellomo, Rinaldo; Bissett, Bernie; Boden, Ianthe J; Bradley, Scott; Burrell, Aidan; Cooper, D James; Fulcher, Bentley J; Haines, Kimberley J; Hopkins, Jack; Jones, Alice Y M; Lane, Stuart; Lawrence, Drew; van der Lee, Lisa; Liacos, Jennifer; Linke, Natalie J; Gomes, Lonni Marques; Nickels, Marc; Ntoumenopoulos, George; Myles, Paul S; Patman, Shane; Paton, Michelle; Pound, Gemma; Rai, Sumeet; Rix, Alana; Rollinson, Thomas C; Sivasuthan, Janani; Tipping, Claire J; Thomas, Peter; Trapani, Tony; Udy, Andrew A; Whitehead, Christina; Hodgson, Isabelle T; Anderson, Shannah; Neto, Ary Serpa.
  • Hodgson CL; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. carol.hodgson@monash.edu.
  • Higgins AM; Department of Intensive Care and Hyperbaric Medicine, The Alfred, Melbourne, Victoria, Australia. carol.hodgson@monash.edu.
  • Bailey MJ; Department of Physiotherapy, The Alfred, Melbourne, Victoria, Australia. carol.hodgson@monash.edu.
  • Mather AM; Department of Critical Care, School of Medicine, University of Melbourne, Victoria, Australia. carol.hodgson@monash.edu.
  • Beach L; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
  • Bellomo R; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
  • Bissett B; Department of Critical Care, School of Medicine, University of Melbourne, Victoria, Australia.
  • Boden IJ; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
  • Bradley S; Department of Physiotherapy (Allied Health), The Royal Melbourne Hospital, Melbourne, Victoria, Australia.
  • Burrell A; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
  • Cooper DJ; Department of Critical Care, School of Medicine, University of Melbourne, Victoria, Australia.
  • Fulcher BJ; Data Analytics Research and Evaluation (DARE) Centre, Austin Hospital, Melbourne, Victoria, Australia.
  • Haines KJ; Discipline of Physiotherapy, University of Canberra, Canberra, Australia.
  • Hopkins J; Physiotherapy Department, Canberra Hospital, Canberra, Australia.
  • Jones AYM; Physiotherapy Department, Launceston General Hospital, Launceston, Tasmania, Australia.
  • Lane S; Launceston Clinical School, University of Tasmania, Tasmania, Australia.
  • Lawrence D; Department of Physiotherapy, The Alfred, Melbourne, Victoria, Australia.
  • van der Lee L; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
  • Liacos J; Department of Intensive Care and Hyperbaric Medicine, The Alfred, Melbourne, Victoria, Australia.
  • Linke NJ; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
  • Gomes LM; Department of Intensive Care and Hyperbaric Medicine, The Alfred, Melbourne, Victoria, Australia.
  • Nickels M; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
  • Ntoumenopoulos G; Physiotherapy Department, Western Health, Melbourne, Victoria, Australia.
  • Myles PS; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
  • Patman S; School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia.
  • Paton M; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
  • Pound G; Intensive Care Medicine Nepean Hospital, New South Wales, Australia.
  • Rai S; Department of Physiotherapy, The Alfred, Melbourne, Victoria, Australia.
  • Rix A; Fiona Stanley Hospital, Perth, Western Australia, Australia.
  • Rollinson TC; Department of Physiotherapy, The Alfred, Melbourne, Victoria, Australia.
  • Sivasuthan J; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
  • Tipping CJ; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
  • Thomas P; Physiotherapy Department, Princess Alexandra Hospital, Metro South Health, Queensland, Australia.
  • Trapani T; Physiotherapy, St Vincent's Hospital, Sydney, New South Wales, Australia.
  • Udy AA; Department of Anaesthesiology and Perioperative Medicine, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
  • Whitehead C; Faculty of Medicine, Nursing and Midwifery, Health Sciences and Physiotherapy, The University of Notre Dame Australia, Perth, Western Australia, Australia.
  • Hodgson IT; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
  • Anderson S; Department of Physiotherapy, Monash Health, Melbourne, Victoria, Australia.
  • Neto AS; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Crit Care ; 25(1): 382, 2021 11 08.
Article in English | MEDLINE | ID: covidwho-1506095
ABSTRACT

BACKGROUND:

There are few reports of new functional impairment following critical illness from COVID-19. We aimed to describe the incidence of death or new disability, functional impairment and changes in health-related quality of life of patients after COVID-19 critical illness at 6 months.

METHODS:

In a nationally representative, multicenter, prospective cohort study of COVID-19 critical illness, we determined the prevalence of death or new disability at 6 months, the primary outcome. We measured mortality, new disability and return to work with changes in the World Health Organization Disability Assessment Schedule 2.0 12L (WHODAS) and health status with the EQ5D-5LTM.

RESULTS:

Of 274 eligible patients, 212 were enrolled from 30 hospitals. The median age was 61 (51-70) years, and 124 (58.5%) patients were male. At 6 months, 43/160 (26.9%) patients died and 42/108 (38.9%) responding survivors reported new disability. Compared to pre-illness, the WHODAS percentage score worsened (mean difference (MD), 10.40% [95% CI 7.06-13.77]; p < 0.001). Thirteen (11.4%) survivors had not returned to work due to poor health. There was a decrease in the EQ-5D-5LTM utility score (MD, - 0.19 [- 0.28 to - 0.10]; p < 0.001). At 6 months, 82 of 115 (71.3%) patients reported persistent symptoms. The independent predictors of death or new disability were higher severity of illness and increased frailty.

CONCLUSIONS:

At six months after COVID-19 critical illness, death and new disability was substantial. Over a third of survivors had new disability, which was widespread across all areas of functioning. Clinical trial registration NCT04401254 May 26, 2020.
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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Critical Illness / Disabled Persons / Recovery of Function / Return to Work / COVID-19 Subject: Critical Illness / Disabled Persons / Recovery of Function / Return to Work / COVID-19 Type of study: Controlled clinical trial / Diagnostic study / Etiology study / Incidence study / Observational study / Patient-preference / Prognostic study / Risk factors Language: English Journal: Crit Care Clinical aspect: Etiology / Prediction / Prognosis / Therapy Year: 2021

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Critical Illness / Disabled Persons / Recovery of Function / Return to Work / COVID-19 Subject: Critical Illness / Disabled Persons / Recovery of Function / Return to Work / COVID-19 Type of study: Controlled clinical trial / Diagnostic study / Etiology study / Incidence study / Observational study / Patient-preference / Prognostic study / Risk factors Language: English Journal: Crit Care Clinical aspect: Etiology / Prediction / Prognosis / Therapy Year: 2021
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