Post intensive care syndrome in survivors of COVID-19 who required mechanical ventilation during the third wave of the pandemic: A prospective study.
Ezequiel Martínez, Cintia Aguilera, Diego Márquez and 12 others
PMID 37348211WHAT IT FOUND
64% of 22 survivors of COVID-19 ARDS with prolonged mechanical ventilation had post intensive care syndrome 30 days after discharge.
Dependence in daily activities was most common, with 41% cognitive impairment and 32% anxiety or depression.
Key findings
01At 30 days after hospital discharge, 14 patients (64%) had PICS, and co-occurrence of impairment in two or more domains was 45%.
02Functional dependence in activities of daily living was common: 14 patients (64%) had Barthel index scores below 100, and all patients with PICS had functional dependence.
03MoCA scores improved from 23.5 points at ICU discharge to 26 points at 30 days after hospital discharge (p = 0.01).
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Only 22 survivors were assessed for PICS after 40 patients were included, so the findings are based on a small sample. There was no control group, so comparisons with other ICU populations are descriptive. Follow-up was only 30 days after hospital discharge, so longer-term recovery was not measured. Pre-existing cognitive and functional status was assessed indirectly from family or GP reports and medical records, not by direct pre-illness testing. Post-traumatic stress was not assessed, which may underestimate psychological impairment. The study was done in two Buenos Aires centers during one pandemic wave, so it may not apply elsewhere. Patients received multiple ICU exposures together, including mechanical ventilation, sedation, neuromuscular blockers, vasopressors and ICU care, so associations cannot identify a single cause.
Declared interests
The Argentine Ministry of Health funded the work through SALUD INVESTIGA scholarships; the authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that any ICU treatment caused PICS or that rehabilitation referral caused worse outcomes. The study had no control group, only 22 patients were assessed, and patients received mechanical ventilation, sedation, neuromuscular blockers, vasopressors and ICU care together, so the contribution of any single component cannot be separated.