Six-Month Outcomes in COVID-19 ICU Patients and Their Family Members: A Prospective Cohort Study

Background: The COVID-19 pandemic has resulted in a major influx of intensive care unit (ICU) admissions. Currently, there is limited knowledge on the long-term outcomes of COVID-19 ICU-survivors and the impact on family members. This study aimed to gain an insight into the long-term physical, social and psychological functioning of COVID-19 ICU-survivors and their family members at three- and six-months following ICU discharge. Methods: A single-center, prospective cohort study was conducted among COVID-19 ICU-survivors and their family members. Participants received questionnaires at three and six months after ICU discharge. Physical functioning was evaluated using the MOS Short-Form General Health Survey, Clinical Frailty Scale and spirometry tests. Social functioning was determined using the McMaster Family Assessment Device and return to work. Psychological functioning was assessed using the Hospital Anxiety and Depression Scale. Results: Sixty COVID-19 ICU-survivors and 78 family members participated in this study. Physical functioning was impaired in ICU-survivors as reflected by a score of 33.3 (IQR 16.7–66.7) and 50 (IQR 16.7–83.3) out of 100 at 3- and 6-month follow-ups, respectively. Ninety percent of ICU-survivors reported persistent symptoms after 6 months. Social functioning was impaired since 90% of COVID-19 ICU-survivors had not reached their pre-ICU work level 6 months after ICU-discharge. Psychological functioning was unaffected in COVID-19 ICU-survivors. Family members experienced worse work status in 35% and 34% of cases, including a decrease in work rate among 18.3% and 7.4% of cases at 3- and 6-months post ICU-discharge, respectively. Psychologically, 63% of family members reported ongoing impaired well-being due to the COVID-19-related mandatory physical distance from their relatives. Conclusion: COVID-19 ICU-survivors suffer from a prolonged disease burden, which is prominent in physical and social functioning, work status and persisting symptoms among 90% of patients. Family members reported a reduction in return to work and impaired well-being. Further research is needed to extend the follow-up period and study the effects of standardized rehabilitation in COVID-19 patients and their family members.

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Long-Term Outcomes in COVID-19 ICU Patients: A Prospective Cohort Study

10.21203/rs.3.rs-395294/v1 ◽

2021 ◽

Author(s):

Nadine Van Veenendaal ◽

Ingeborg Van der Meulen ◽

Marisa Onrust ◽

Wolter Paans ◽

Willem Dieperink ◽

...

Keyword(s):

Cohort Study ◽

Intensive Care ◽

Psychological Functioning ◽

Employment Status ◽

Family Members ◽

Well Being ◽

Long Term Outcomes ◽

Icu Discharge

Abstract BACKGROUNDThe COVID-19 pandemic causes high rates of intensive care unit (ICU) admissions. After ICU-discharge patients and family members can suffer from persisting impairments known as ‘Post Intensive Care Syndrome’ (PICS) and PICS-family. Since COVID-19 is relatively new, there is barely any knowledge on the long-term outcomes of COVID-19 ICU-survivors and their family members.OBJECTIVESThis study aims to gain insight in the long-term physical, social and psychological functioning of COVID-19 ICU-survivors and their family members at three- and six-months following ICU discharge.METHODSA single-center, prospective cohort study was conducted in COVID-19 ICU-survivors and their family members. Enrolled participants received questionnaires at three and six months after ICU discharge. The MOS Short-Form General Health Survey, Clinical Frailty Scale, spirometry tests, McMaster Family Assessment Device (FAD-GF6+), the Hospital Anxiety and Depression Scale and return to work were used to evaluate physical, social and psychological functioning.RESULTSSixty COVID-19 ICU-survivors and 78 family members participated. Physical functioning was impaired in ICU-survivors as reflected by a score of 33.3 (IQR 16.7-66.7) and 50 (IQR 16.7-83.3) on the physical functioning subscale at 3- and 6-months follow-up respectively. Diffusion lung capacity was reduced in 69% of patients. Ninety percent of the ICU-survivors reported persistent symptoms after 6 months. Social functioning was impaired as 90% of the COVID-19 ICU-survivors did not reach their pre-ICU employment level, 6 months after ICU-discharge. Psychological functioning in ICU-survivors was normal. Family members experienced worse employment status in 35% and 34% including a decrease in employment rate of 18.3% and 7.4% at 3- and 6-months post ICU-discharge, respectively. Psychologically, 63% of the family members reported ongoing impaired well-being due to the COVID-19 related mandatory physical distance to their relatives.CONCLUSIONWe have shown that COVID-19 ICU-survivors suffer from a prolonged burden of disease, prominent in physical- and social functioning, worse employment status and persisting symptoms in 90%. In addition, family members also report long term effects expressed by a reduction in return to work and impaired well-being. Further research needs to extend the follow up and to study the effects of standardized rehabilitation in COVID-19 patients and their family members.

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612 Assessing the Impact of Burns on Children Aged 5–18 Years: A Narrative Review of Health Outcomes Literature

Journal of Burn Care & Research ◽

10.1093/jbcr/iraa024.238 ◽

2020 ◽

Vol 41 (Supplement_1) ◽

pp. S150-S150

Author(s):

Amelia Austen ◽

Carina Hou ◽

Khushbu Patel ◽

Keri Brady ◽

Gabrielle G Grant ◽

...

Keyword(s):

Quality Of Life ◽

Health Outcomes ◽

Social Functioning ◽

Physical Functioning ◽

Psychological Functioning ◽

Burn Injury ◽

Health Domains ◽

The Impact

Abstract Introduction Burn injuries can have major long-term effects on the health and quality of life for children and adolescents. This study narratively reviewed the health outcomes literature focusing on the impact of burn injury for children aged 5–18. Methods Literature targeting pediatric outcomes was reviewed to identify the effects of burns on children aged 5–18 (n=16). Inclusion criteria included studies that focused on the impact of burns on health and quality of life and were age-appropriate for this population. Articles were identified via PubMed, Web of Science, and manual reference checks. Data collected included the outcomes and health domains assessed in each article and the findings of the effects of the burn injury on those specific outcomes. The Preschool LIBRE Conceptual Model served as a ‘domains framework’ to guide the identification of outcomes and health domains. Results Long-term burn-specific outcomes and broad health domains identified were physical functioning (n=9), psychological functioning (n=12), social functioning (n=4), symptoms (n=8), and family (n=7). Some studies exclusively focused on one domain whereas others assessed two domains or more. Subdomains such as upper extremity functioning and functional independence were addressed in the physical functioning domain. Psychological functioning outcomes included subdomains such as emotional health and behavioral problems. Social functioning outcomes evaluated subdomains such as problems with peers and social participation. The symptoms domain addressed post-burn pain and itch. Family outcomes subdomains such as parental satisfaction with appearance and general family functioning were identified. Conclusions Burn-specific outcomes and health domains assessing the effects of burns on children aged 5–18 were identified among 16 studies. There is a need for a comprehensive assessment tool that more precisely measures the impact of burn injury across these domains. This work will inform the development of the School-Aged Life Impact Burn Recovery Evaluation (LIBRE) Computer Adaptive Test (CAT) Profile – a new outcome metric for children and adolescents with burns. Applicability of Research to Practice This review is relevant to researchers and clinicians assessing health outcomes and measuring burn recovery in children aged 5–18.

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Smoking and quality of life among elderly survivors of non-smoking related cancers in a prospective cohort study

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.9600 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. 9600-9600

Author(s):

S. Jang ◽

A. Prizment ◽

D. Lazovich

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Physical Activity ◽

Cohort Study ◽

Social Functioning ◽

Physical Functioning ◽

Prospective Cohort ◽

General Health ◽

Sf 36

9600 Background: Although the effect of smoking on quality of life (QOL) has been examined among survivors of lung or head and neck cancers, little is known about how smoking affects QOL among elderly survivors of non-smoking related cancers. Methods: The Iowa Women's Health Study (IWHS), a prospective cohort study initiated in 1986, collected self-reported QOL using the SF-36 in 2004. Cancer diagnosis and treatment among cohort participants were obtained from Iowa's cancer registry. Behavioral and health characteristics, including smoking status, were collected from periodic follow-up questionnaires between 1986 and 2004. We included 1,920 women, aged 55 to 69 years at baseline, who developed breast, colorectal, or endometrial cancers and responded to the 2004 questionnaire. We compared age-adjusted and multivariate-adjusted mean scores for eight SF-36 scales between nonsmokers (no reported smoking in 1986 or 2004), quitters (reported smoking in 1986 but not 2004), and persistent smokers (reported smoking in 1986 and 2004). Results: Among 1,920 cancer survivors, 1,720 (89.6%) were nonsmokers, 141 (7.3%) were quitters, and 59 (3.1%) were persistent smokers. After age adjustment, quitters had lower scores for vitality, physical functioning, mental health, social functioning, and general health scales compared to nonsmokers. Persistent smokers scored worse on the physical functioning, mental health, role emotional, and social functioning scales compared to nonsmokers. Except for mental health, these differences in QOL scores were attenuated after further adjustment for physical activity. Accounting for other factors, including baseline general health perception and education, cancer type, surgery, radiation therapy, chemotherapy, and length of survival, or occurrence of hypertension, diabetes, heart disease, stroke or fracture by 2004 did not change the differences observed between survivors who had ever reported smoking versus nonsmokers. Conclusions: Quitters and persistent smokers tended to fare worse than nonsmokers on many QOL scales. In most instances, these differences were explained by lower levels of physical activity which may have been a consequence of smoking. No significant financial relationships to disclose.

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