Quality of life of COVID-19 critically ill survivors after ICU discharge: 90 days follow-up

Lorenzo Gamberini, Carlo Alberto Mazzoli, Harri Sintonen, Davide Colombo, Gaetano Scaramuzzo, Davide Allegri, Tommaso Tonetti, Gianluca Zani, Chiara Capozzi, Emanuela Giampalma, Vanni Agnoletti, Filippo Becherucci, Elisabetta Bertellini, Andrea Castelli, Iacopo Cappellini, Irene Cavalli, Federico Crimaldi, Federica Damiani, Maurizio Fusari, Giovanni Gordini, Cristiana Laici, Maria Concetta Lanza, Mirco Leo, Andrea Marudi, Giuseppe Nardi, Irene Ottaviani, Raffaella Papa, Antonella Potalivo, Vito Marco Ranieri, Emanuele Russo, Stefania Taddei, Carlo Alberto Volta, Savino Spadaro, ICU-RER COVID-19 Collaboration, Marco Tartaglione, Valentina Chiarini, Virginia Buldini, Carlo Coniglio, Federico Moro, Clara Barbalace, Mario Citino, Nicola Cilloni, Lorenzo Giuntoli, Angela Bellocchio, Emanuele Matteo, Giacinto Pizzilli, Antonio Siniscalchi, Chiara Tartivita, Francesco Matteo, Annalisa Marchio, Igor Bacchilega, Laura Bernabé, Sonia Guarino, Elena Mosconi, Luca Bissoni, Lorenzo Viola, Emiliano Gamberini, Tommaso Meconi, Vittorio Pavoni, Aline Pagni, Patrizia Pompa Cleta, Marco Cavagnino, Anna Malfatto, Angelina Adduci, Silvia Pareschi, Gabriele Melegari, Jessica Maccieri, Elisa Marinangeli, Fabrizio Racca, Marco Verri, Giulia Falò, Elisabetta Marangoni, Francesco Boni, Giulia Felloni, Federico Domenico Baccarini, Marina Terzitta, Stefano Maitan, Maddalena Parise, Bernardo Bugiani, Francesca Masoni, Lorenzo Gamberini, Carlo Alberto Mazzoli, Harri Sintonen, Davide Colombo, Gaetano Scaramuzzo, Davide Allegri, Tommaso Tonetti, Gianluca Zani, Chiara Capozzi, Emanuela Giampalma, Vanni Agnoletti, Filippo Becherucci, Elisabetta Bertellini, Andrea Castelli, Iacopo Cappellini, Irene Cavalli, Federico Crimaldi, Federica Damiani, Maurizio Fusari, Giovanni Gordini, Cristiana Laici, Maria Concetta Lanza, Mirco Leo, Andrea Marudi, Giuseppe Nardi, Irene Ottaviani, Raffaella Papa, Antonella Potalivo, Vito Marco Ranieri, Emanuele Russo, Stefania Taddei, Carlo Alberto Volta, Savino Spadaro, ICU-RER COVID-19 Collaboration, Marco Tartaglione, Valentina Chiarini, Virginia Buldini, Carlo Coniglio, Federico Moro, Clara Barbalace, Mario Citino, Nicola Cilloni, Lorenzo Giuntoli, Angela Bellocchio, Emanuele Matteo, Giacinto Pizzilli, Antonio Siniscalchi, Chiara Tartivita, Francesco Matteo, Annalisa Marchio, Igor Bacchilega, Laura Bernabé, Sonia Guarino, Elena Mosconi, Luca Bissoni, Lorenzo Viola, Emiliano Gamberini, Tommaso Meconi, Vittorio Pavoni, Aline Pagni, Patrizia Pompa Cleta, Marco Cavagnino, Anna Malfatto, Angelina Adduci, Silvia Pareschi, Gabriele Melegari, Jessica Maccieri, Elisa Marinangeli, Fabrizio Racca, Marco Verri, Giulia Falò, Elisabetta Marangoni, Francesco Boni, Giulia Felloni, Federico Domenico Baccarini, Marina Terzitta, Stefano Maitan, Maddalena Parise, Bernardo Bugiani, Francesca Masoni

Abstract

Purpose: The onset of the coronavirus disease 19 (COVID-19) pandemic in Italy induced a dramatic increase in the need for intensive care unit (ICU) beds for a large proportion of patients affected by COVID-19-related acute respiratory distress syndrome (ARDS). The aim of the present study was to describe the health-related quality of life (HRQoL) at 90 days after ICU discharge in a cohort of COVID-19 patients undergoing invasive mechanical ventilation and to compare it with an age and sex-matched sample from the general Italian and Finnish populations. Moreover, the possible associations between clinical, demographic, social factors, and HRQoL were investigated.

Methods: COVID-19 ARDS survivors from 16 participating ICUs were followed up until 90 days after ICU discharge and the HRQoL was evaluated with the 15D instrument. A parallel cohort of age and sex-matched Italian population from the same geographic areas was interviewed and a third group of matched Finnish population was extracted from the Finnish 2011 National Health survey. A linear regression analysis was performed to evaluate potential associations between the evaluated factors and HRQoL.

Results: 205 patients answered to the questionnaire. HRQoL of the COVID-19 ARDS patients was significantly lower than the matched populations in both physical and mental dimensions. Age, sex, number of comorbidities, ARDS class, duration of invasive mechanical ventilation, and occupational status were found to be significant determinants of the 90 days HRQoL. Clinical severity at ICU admission was poorly correlated to HRQoL.

Conclusion: COVID-19-related ARDS survivors at 90 days after ICU discharge present a significant reduction both on physical and psychological dimensions of HRQoL measured with the 15D instrument.

Trial registration: NCT04411459.

Keywords: 15D instrument; Acute respiratory distress syndrome; COVID-19; Coronavirus; Health-related quality of life.

Conflict of interest statement

Harri Sintonen is the developer of the 15D and obtains royalties from its electronic versions. The other Authors have nothing to disclose.

© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.

Figures

Fig. 1
Fig. 1
Patients flow through the study
Fig. 2
Fig. 2
15D profile of the COVID-19-related ARDS survivors compared with age- and sex-matched Italian and Finnish populations

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