Post-intensive care COVID survivorship clinic: a single centre experience

ABSTRACT

Introduction: Patients discharged from the intensive care unit (ICU) post coronavirus-19 (COVID-19) pneumonitis may experience longterm morbidity related to their critical illness, the treatment for this and the ICU environment. Methods: We performed a prospective cohort study in a post-ICU (PICS) follow-up clinic at Tallaght University Hospital in October 2020 for patients who had been admitted to the ICU in our institution with COVID-19 pneumonitis six months earlier. Our clinic was staffed by critical care physicians, a psychologist, a physiotherapist and a research nurse. Our aim was to characterise the cognitive, psychological and physical consequences of COVID-19 in patients admitted to the ICU and discharged alive. Results: A total of 22 patients attended the 6-month PICS follow-up clinic following admission to ICU with COVID-19 pneumonitis. The majority of these patients were male and obese. The most common comorbidities were hypertension, diabetes mellitus and ischaemic heart disease. The median ICU length of stay was 21 days (IQR 2-75 days) with a median hospital length of stay of 37 days (IQR 8-130 days). The mean ICU Mobility Scale (IMS) score at the PICS clinic was low at 9.8 (SD 0.4). Only 59% of patients were independent with regard to their activities of daily living (ADLs). 8/14 (57%) of patients had returned to work by 6 months post ICU discharge. Their mean Intensive Care Psychological Assessment Tool (IPAT) score was high at 6.7 (SD 4.6) with a high mean Post-Traumatic Stress Disorder (PTSD) score of 21.1 (SD 17.5). Conclusions: In this single centre prospective cohort study, we found that patients have a high burden of physical and psychological impairment at 6 months following ICU discharge post COVID-19 pneumonitis;in many cases requiring specialist referrals for long-term input. We advocate for increased resources for this much needed follow-up multidisciplinary intervention for an ever-growing population of patients.