Respiratory medicine · 2026
Long-Term Psychological, Cognitive and Quality of Life Outcomes in Covid-19 Severe Acute Respiratory Failure patients managed with Extracorporeal Membrane Oxygenation.
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Singh V E R, Garfield B E, Singh S, Doyle A-M
Аннотация
OBJECTIVES: ICU admission with severe acute respiratory failure (SARF) can result in extended recovery and rehabilitation. We sought to evaluate the long-term psychological, cognitive and quality of life outcomes of Covid-19 SARF patients to inform our understanding of the longer-term health burden to survivors.
DESIGN: Retrospective single centre cohort study.
SETTING AND PATIENTS: All surviving SARF Covid-19 patients admitted to a regional ECMO centre in London between March 2020 - February 2022 attending ICU follow-up clinic.
INTERVENTIONS: None MEASUREMENTS AND MAIN RESULTS: CORE ICU validated outcome measures alongside clinical interview. Of the surviving (n = 116) patients, 97 (83.6%) attended at least one ICU follow-up clinic. For those attending multiple reviews, despite an improvement in quality of life, depression, anxiety and PTSD were no different between 0 - 2 years and 2 - 4 years after discharge. Comprehensive long-term reviews held between 18 months and 4 years [ IQR 17.5 m - 44.8 m ] following discharge, n = 87) found prevalence of depression (44%), anxiety (25%) and PTSD (33%). Half were still receiving care from specialist healthcare teams. Cognitive impairment was seen in 63% and functional impairment in 31%. Over a quarter (26%) remained not working. Depression and PTSD scores were lower in those who had returned to work. Thematic analysis of long-term reviews revealed six key themes: a plateaued recovery, the traumatising experience, forgetfulness, family strain, appreciation and gratitude, and awareness of the fragility of life.
CONCLUSION: Despite improvements to quality of life, impairments in psychological, cognitive and aspects of health-related quality of life can persist as long as four years after discharge in SARF ECMO survivors. Qualitative findings illustrated the enduring impact of critical illness alongside themes of gratitude an altered life perspective.
DESIGN: Retrospective single centre cohort study.
SETTING AND PATIENTS: All surviving SARF Covid-19 patients admitted to a regional ECMO centre in London between March 2020 - February 2022 attending ICU follow-up clinic.
INTERVENTIONS: None MEASUREMENTS AND MAIN RESULTS: CORE ICU validated outcome measures alongside clinical interview. Of the surviving (n = 116) patients, 97 (83.6%) attended at least one ICU follow-up clinic. For those attending multiple reviews, despite an improvement in quality of life, depression, anxiety and PTSD were no different between 0 - 2 years and 2 - 4 years after discharge. Comprehensive long-term reviews held between 18 months and 4 years [ IQR 17.5 m - 44.8 m ] following discharge, n = 87) found prevalence of depression (44%), anxiety (25%) and PTSD (33%). Half were still receiving care from specialist healthcare teams. Cognitive impairment was seen in 63% and functional impairment in 31%. Over a quarter (26%) remained not working. Depression and PTSD scores were lower in those who had returned to work. Thematic analysis of long-term reviews revealed six key themes: a plateaued recovery, the traumatising experience, forgetfulness, family strain, appreciation and gratitude, and awareness of the fragility of life.
CONCLUSION: Despite improvements to quality of life, impairments in psychological, cognitive and aspects of health-related quality of life can persist as long as four years after discharge in SARF ECMO survivors. Qualitative findings illustrated the enduring impact of critical illness alongside themes of gratitude an altered life perspective.