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Comparison of 6-Month Outcomes of Survivors of COVID-19 versus Non–COVID-19 Critical Illness

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, Isabelle T. Hodgson, Jack Hopkins, Alice Y. M. Jones, 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, Claire J. Tipping, Peter Thomas, Tony Trapani, Andrew A. Udy, Christina Whitehead, Shannah Anderson, Ary Serpa Neto

2022American Journal of Respiratory and Critical Care Medicine93 citationsDOIOpen Access PDF

Abstract

Abstract Rationale The outcomes of survivors of critical illness due to coronavirus disease (COVID-19) compared with non–COVID-19 are yet to be established. Objectives We aimed to investigate new disability at 6 months in mechanically ventilated patients admitted to Australian ICUs with COVID-19 compared with non–COVID-19. Methods We included critically ill patients with COVID-19 and non–COVID-19 from two prospective observational studies. Patients were eligible if they were adult (age ⩾ 18 yr) and received ⩾24 hours of mechanical ventilation. In addition, patients with COVID-19 were eligible with a positive laboratory PCR test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Measurements and Main Results Demographic, intervention, and hospital outcome data were obtained from electronic medical records. Survivors were contacted by telephone for functional outcomes with trained outcome assessors using the World Health Organization Disability Assessment Schedule 2.0. Between March 6, 2020, and April 21, 2021, 120 critically ill patients with COVID-19, and between August 2017 and January 2019, 199 critically ill patients without COVID-19, fulfilled the inclusion criteria. Patients with COVID-19 were older (median [interquartile range], 62 [55–71] vs. 58 [44–69] yr; P = 0.019) with a lower Acute Physiology and Chronic Health Evaluation II score (17 [13–20] vs. 19 [15–23]; P = 0.011). Although duration of ventilation was longer in patients with COVID-19 than in those without COVID-19 (12 [5–19] vs. 4.8 [2.3–8.8] d; P < 0.001), 180-day mortality was similar between the groups (39/120 [32.5%] vs. 70/199 [35.2%]; P = 0.715). The incidence of death or new disability at 180 days was similar (58/93 [62.4%] vs. 99/150 [66/0%]; P = 0.583). Conclusions At 6 months, there was no difference in new disability for patients requiring mechanical ventilation for acute respiratory failure due to COVID-19 compared with non–COVID-19. Clinical trial registered with www.clinicaltrials.gov (NCT04401254).

Topics & Concepts

MedicineObservational studyMechanical ventilationCritical illnessIncidence (geometry)Critically illSeverity of illnessIntensive careProspective cohort studyEmergency medicineAcute illnessIntensive care medicineIllness severityDiseaseAPACHE IIEpidemiologyPediatricsCoronavirus disease 2019 (COVID-19)MEDLINERespiratory illnessMortality rateRespiratory diseaseCohort studyPhysical therapyRespiratory failurePneumoniaSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2)Acute respiratory failureLong-Term Effects of COVID-19COVID-19 Clinical Research StudiesIntensive Care Unit Cognitive Disorders
Comparison of 6-Month Outcomes of Survivors of COVID-19 versus Non–COVID-19 Critical Illness | Litcius