Long-Term Follow-Up of Acute Organ Failure in Survivors of Critical Illness due to COVID-19

First Author(s)

• SC

  Sudham Chand, MD, MBBS.

  Montefiore Medical Center
  Greensboro, North Carolina

  Disclosure information not submitted.

  Slides and Audio

Co-Author(s)

• SK

  Sumit Kapoor, MD, FCCP, CNSC, CPPS

  Associate Professor
  Montefiore Medical Center, United States

  Disclosure information not submitted.
• AN

  Ali Naqvi, MD

  Critical care fellow
  Montefiore Medical Center, United States

  Disclosure information not submitted.
• JT

  JYOTSANA THAKKAR, MD

  Assistant Professor
  JACOBI MEDICAL CENTER, United States

  Disclosure information not submitted.
• MF

  Melissa Fazzari, Ph.D

  Assistant Professor
  Albert Einstein College of Medicine, United States

  Disclosure information not submitted.
• DO

  Deborah Orsi, MD

  Assistant Professor
  Montefiore Medical Center, United States

  Disclosure information not submitted.
• 

  Vladyslav Dieiev, MD, MS

  Critical care Fellow
  Montefiore Medical Center
  Bronx, New York, United States

  Disclosure information not submitted.
• DL

  David Lewandowski, MD, MS

  Critical care fellow
  Montefiore Medical Center, United States

  Disclosure information not submitted.
• PD

  Peter Dicpinigaitis, MD

  Professor
  Albert Einstein Hospital, United States

  Disclosure information not submitted.

Title: Long-term follow up of acute organ failures in survivors of critical illness due to Covid-19



Introduction: Little is known about the long-term health sequelae and outcomes of various organ failures in ICU survivors of Covid-19. The aim of our research was to study the characteristics of 120-day ICU survivors of the initial pandemic surge and report their long term ( >6 months) outcomes.

Methods: We conducted a telephone questionnaire-based follow up study of 120- day survivors of Covid-19 admitted to ICUs at Montefiore Medical Center, Bronx, NY from 3/10/2020-4/11/2020. The study period was 2 months (11/1/2020-12/31/2020).

Results: 126 out of 300 (42%) survived to 120-days post-hospital discharge. The median age of our survivors was 54 (47-61) years. Seventy-eight (62%) patients developed acute kidney injury (AKI); thirty-five (44.9%) of them required renal replacement therapy (RRT). One hundred-five (83.3%) required invasive mechanical ventilation; ten of them required tracheotomy.103 (81.7%) completed the telephone questionnaire-based study, at a median (IQR) of 216.5 (200-234.5) days after hospital discharge. 29 (28.2%) patients reported persistent shortness of breath, 24, (23.3%) complained of persistent cough, and persistent anosmia in 9 (8.8%). AKI resolved completely in 58 (74.4%) patients. Of 35 AKI patients who required initiation of RRT during hospitalization, 27 (77%) were liberated from RRT and 20 (57%) had resolution of AKI. Of 20 patients without AKI resolution, 12 developed chronic kidney disease, whereas 8 still require RRT. Thirty-three (32.4%) patients developed post-traumatic stress disorder (PTSD) and 10 (11.8%) reported major depression. Many of the patients (68%) regained baseline functional status. Readmissions occurred in 22.3% patients within first 6 months after discharge.

Conclusions: ICU survivors of Covid-19 are at greater risk of developing symptoms of long Covid. Outcomes of Covid-19 associated acute kidney injury are excellent. There is a high incidence of PTSD and depression in COVID-19 ICU survivors. Functional outcomes are good, but these patients remain at increased risk of hospital readmission.