.jpg "Alina Kung, MD, MS photo")
Alina Kung, MD, MS
Resident
n/a
Los Angeles, California, United States
Disclosure information not submitted.
Ron Hays, PhD
Doctor
University of California, Los Angeles, United States
Disclosure information not submitted.
Cynthia Garcia
Research Coordinator
University of California, Los Angeles, United States
Disclosure information not submitted.
Lucia Chen, MS
Statistician
University of California, Los Angeles, United States
Disclosure information not submitted.
Myrtle Yamamoto, RN
Quality Manager
UCLA, David Geffen School of Medicine, Department of Medicine, Quality Improvement., United States
Disclosure information not submitted.
Ashley Hong
Undergradaute Student
University of California, Los Angeles, United States
Disclosure information not submitted.
Thanh Neville, MD, MSHS
Doctor
UCLA David Geffen School of Medicine, United States
Disclosure information not submitted.
Title: Long-term functional outcomes following intensive care for severe COVID-19
INTRODUCTION/HYPOTHESIS: Long-term functional outcomes, living situation, and return to work following intensive care for severe COVID-19 have not been adequately characterized. We hypothesize that survivors of severe COVID-19 experience functional impairment across a variety of domains. This information will help us better understand the trajectory of severe COVID-19 and intervene as needed to optimize recovery.
Methods: This prospective cohort study took place in a two-hospital academic system and included adults with COVID-19 discharged from the ICU prior to December 31, 2020. Surveys in English or Spanish were sent at 3- and 6-months from discharge date and included the Patient-Reported Outcomes Measurement Information Survey (PROMIS-29) and questions on living and work situation. The survey that was closest in time to 6 months after hospital discharge was used. One-sample t-tests were used to compare standardized PROMIS scores to a general US population average of 50 (where the standard deviation is 10).
Results: Of 275 patients who were admitted and discharged from the ICU prior to December 31, 2020, 70 patients died in the hospital. An additional 10 patients died before 1 month post discharge. Two thirds of eligible patients (n=132/195) completed follow-up surveys.
Participants reported decreased physical function (mean 44.2, SD 11.0) compared to the general public (mean 50, SD 10, p< 0.001). Most (n=122, 93%) were living at home with few living in assisted living, skilled nursing, or other facilities. Approximately 1 in 6 patients newly required a caregiver after their illness (n= 21, 16%). Out of 68 patients who were working before COVID-19, 58.8% (n=40) had returned to work. PROMIS-29 scores on fatigue, pain interference, sleep disturbance, and ability to participate in social roles/activities were similar to that of the general public.
Conclusions: Our findings suggest debilitation following severe COVID-19 requiring intensive care affects specific domains. Although a substantive minority (16%) of patients newly required a caregiver, and roughly 40% of those previously employed had not yet returned to work, patients reported outcomes similar to the general public on most domains. Rehabilitation resources should be targeted to meet needs including physical impairment and return to work.