key: cord-0792299-hcok8sh0
authors: McCue, Claire; Cowan, Richard; Quasim, Tara; Puxty, Kathryn; McPeake, Joanne
title: Long term outcomes of critically ill COVID-19 pneumonia patients: early learning
date: 2020-11-09
journal: Intensive Care Med
DOI: 10.1007/s00134-020-06313-x
sha: 2b7fc5eb4d7a8d5d775d2714b622d33785564a3e
doc_id: 792299
cord_uid: hcok8sh0

nan

confirmed with reverse RT-PCR assay for SARS-CoV-2, except for one patient who died prior to a sputum sample being obtained. Complete records of 43 patients were available for review. Of the 43 patients examined, 33 (77%) were male and the median age was 57 (IQR 52.5-65.5). 27 (63%) patients had 1 or more comorbidity. ICU mortality was 33%, median ICU length of stay 17.9 days (IQR 7.4-26.5) and the median duration of ventilation was also 17.9 (IQR 6.5-24). Most (93%) patients developed severe acute respiratory distress syndrome (ARDS) during their admission (P/F or S/F ratio < 13.3 kPa) and 37 (86%) received neuromuscular blockade with a median of 6 (IQR 2.5-11) days paralysis. Sixty percent of patients were proned at least once (Table 1) .

Of the 30 survivors with full data available, 24 (80%) attended follow up. Outcome data were available from 21 patients; one patient declined inclusion; one was readmitted to hospital following their consultation and could not participate in the research and one agreed to participate but could not be contacted following clinic. The median HUS was 0.752 (IQR 0.627-0.837). Fifteen patients were employed pre-ICU. When reviewed at follow-up, 7 (47%) had returned to work and 1 (7%) had taken voluntary retirement. One (7%) patient was planning to return to work in the week following clinic attendance. New disability including breathlessness were reported as impacting on employability; a small number of patients described they were unable to return to work due to COVID-19 employment restrictions. Fourteen (67%) patients complained of new pain; 29% of pain was classified as severe or extreme.

This cohort had a significant burden of acute illness requiring prolonged mechanical ventilation and high rates of neuromuscular blockade. Despite this, we report meaningful early recovery including increased return to employment in a single centre, from a small sample [5] . However, caution should be taken with the interpretation *Correspondence: joanne.mcpeake@glasgow.ac.uk of these outcomes, as employment status can fluctuate following critical illness [5] . Furthermore, HRQoL was similar to a previous ARDS cohort (Median HUS, 0.77) and better than a previous cohort of survivors from our own centre (Median HUS, 0.29) [3, 6] . Two thirds of patients experienced ongoing, new pain following discharge, a finding which requires further investigation.

The online version of this article (https ://doi.org/10.1007/s0013 4-020-06313 -x) contains supplementary material, which is available to authorized users. 

Clinical features, ventilatory management, and outcome of ARDS caused by COVID-19 are similar to other causes of ARDS

Recovery and outcomes after acute respiratory distress syndrome (ARDS) in patients and their family caregivers

Intensive care syndrome: promoting independence and return to employment (InS:PIRE). Early evaluation of a complex intervention

A new tool for creating personal and social EQ-5D-5L value sets, including value 'dead

Return to employment following critical illness and its association with psychosocial outcomes: a systematic review and meta-analysis

Predictors of 6-month health utility outcomes in survivors of acute respiratory distress syndrome

The authors have no conflicts of interest to declare.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.Accepted: 23 October 2020