Post-intensive care syndrome at 6 months and 1 year among survivors of severe COVID-19 requiring invasive mechanical ventilation: a single-center observational study.

Purpose

Long-term multidomain impairment after critical coronavirus disease 2019 (COVID-19) overlaps with post-intensive care syndrome (PICS) and post-COVID-19 condition. We assessed PICS at 6 months and 1 year after hospital discharge and explored associated clinical factors in Japanese patients with COVID-19 requiring invasive mechanical ventilation.

Methods

This single-center observational study included adult patients with COVID-19 who required invasive mechanical ventilation and survived to discharge. PICS was assessed using the Barthel Index, Short-Memory Questionnaire, and Hospital Anxiety and Depression Scale. Exploratory multivariable logistic regression examined factors associated with 1-year PICS.

Results

Of 67 discharged survivors, 37 completed both 6-month and 1-year assessments; 17 (45.9%) received extracorporeal membrane oxygenation. PICS was present in 22 (59.5%) patients at 6 months and 21 (56.8%) at 1 year, and 15 (40.5%) had cognitive impairment at both assessments. Delirium was more frequent in patients with PICS than in those without at 6 months (63.6% vs 26.7%, p=0.045) and 1 year (66.7% vs 25.0%, p=0.020). In the exploratory multivariable analysis, delirium was associated with 1-year PICS after adjustment for age and mechanical ventilation duration (odds ratio, 7.09; 95% confidence interval, 1.54-32.7; p=0.012).

Conclusions

PICS was common 6 months and 1 year after hospital discharge among survivors of severe COVID-19. In an exploratory analysis, delirium was associated with 1-year PICS after adjustment for age and mechanical ventilation duration. This hypothesis-generating finding requires confirmation in larger prospective cohorts.