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Prevalence, characteristics, and longer-term outcomes of patients with persistent critical illness attributable to COVID-19 in Scotland: a national cohort study.
Blayney, Michael C; Stewart, Neil I; Kaye, Callum T; Puxty, Kathryn; Chan Seem, Robert; Donaldson, Lorraine; Haddow, Catriona; Hall, Ros; Martin, Caroline; Paton, Martin; Lone, Nazir I; McPeake, Joanne.
  • Blayney MC; Usher Institute, University of Edinburgh, Edinburgh, UK; Public Health Scotland, UK; Department of Critical Care, NHS Lothian, Edinburgh, UK.
  • Stewart NI; Department of Critical Care, NHS Forth Valley, Larbert, UK.
  • Kaye CT; Department of Critical Care, NHS Grampian, Aberdeen, UK.
  • Puxty K; Department of Critical Care, NHS Greater Glasgow and Clyde, Glasgow, UK; School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK.
  • Chan Seem R; Public Health Scotland, UK.
  • Donaldson L; Public Health Scotland, UK.
  • Haddow C; Public Health Scotland, UK.
  • Hall R; Public Health Scotland, UK.
  • Martin C; Public Health Scotland, UK.
  • Paton M; Public Health Scotland, UK.
  • Lone NI; Usher Institute, University of Edinburgh, Edinburgh, UK; Department of Critical Care, NHS Lothian, Edinburgh, UK. Electronic address: nazir.lone@ed.ac.uk.
  • McPeake J; Department of Critical Care, NHS Greater Glasgow and Clyde, Glasgow, UK; School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK.
Br J Anaesth ; 128(6): 980-989, 2022 06.
Article in English | MEDLINE | ID: covidwho-1828009
ABSTRACT

BACKGROUND:

Patients with COVID-19 can require critical care for prolonged periods. Patients with persistent critical Illness can have complex recovery trajectories, but this has not been studied for patients with COVID-19. We examined the prevalence, risk factors, and long-term outcomes of critically ill patients with COVID-19 and persistent critical illness.

METHODS:

This was a national cohort study of all adults admitted to Scottish critical care units with COVID-19 from March 1, 2020 to September 4, 20. Persistent critical illness was defined as a critical care length of stay (LOS) of ≥10 days. Outcomes included 1-yr mortality and hospital readmission after critical care discharge. Fine and Gray competing risk analysis was used to identify factors associated with persistent critical Illness with death as a competing risk.

RESULTS:

A total of 2236 patients with COVID-19 were admitted to critical care; 1045 patients were identified as developing persistent critical Illness, comprising 46.7% of the cohort but using 80.6% of bed-days. Patients with persistent critical illness used more organ support, had longer post-critical care LOS, and longer total hospital LOS. Persistent critical illness was not significantly associated with long-term mortality or hospital readmission. Risk factors associated with increased hazard of persistent critical illness included age, illness severity, organ support on admission, and fewer comorbidities.

CONCLUSIONS:

Almost half of all patients with COVID-19 admitted to critical care developed persistent critical illness, with high resource use in critical care and beyond. However, persistent critical illness was not associated with significantly worse long-term outcomes compared with patients who were critically ill for shorter periods.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Critical Illness / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Humans Language: English Journal: Br J Anaesth Year: 2022 Document Type: Article Affiliation country: J.bja.2022.03.017

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Critical Illness / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Humans Language: English Journal: Br J Anaesth Year: 2022 Document Type: Article Affiliation country: J.bja.2022.03.017