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Multicenter Study
The impact of COVID-19 critical illness on new disability, functional outcomes and return to work at 6 months: a prospective cohort study.
- Carol L Hodgson, Alisa M Higgins, Michael J Bailey, Anne M Mather, Lisa Beach, Rinaldo Bellomo, Bernie Bissett, Ianthe J Boden, Scott Bradley, Aidan Burrell, D James Cooper, Bentley J Fulcher, Kimberley J Haines, Jack Hopkins, JonesAlice Y MAYMSchool of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia., Stuart Lane, Drew Lawrence, Lisa van der Lee, Jennifer Liacos, Natalie J Linke, Lonni Marques Gomes, Marc Nickels, George Ntoumenopoulos, Paul S Myles, Shane Patman, Michelle Paton, Gemma Pound, Sumeet Rai, Alana Rix, Thomas C Rollinson, Janani Sivasuthan, Claire J Tipping, Peter Thomas, Tony Trapani, Andrew A Udy, Christina Whitehead, Isabelle T Hodgson, Shannah Anderson, NetoAry SerpaASAustralian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.Department of Physiotherapy (Allied Health), The Royal Melbourne Hospital, Melbour, and COVID-Recovery Study Investigators and the ANZICS Clinical Trials Group.
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. carol.hodgson@monash.edu.
- Crit Care. 2021 Nov 8; 25 (1): 382382.
BackgroundThere 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.MethodsIn 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.ResultsOf 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.ConclusionsAt 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.© 2021. The Author(s).
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