Comparison of health-related quality of life after intensive care in patients before versus during the COVID pandemic

Abstract

Background: Health-related quality of life (HRQL) is commonly reduced after critical illness and intensive care unit (ICU) stay. The coronavirus disease (COVID-19) pandemic challenged regular medical standards, potentially influencing HRQL post-ICU patients. However, whether patients treated in the ICU due to COVID-19 report worse or better HRQL compared to patients admitted to the ICU before the pandemic is unclear and remains to be evaluated

Aim: To evaluate HRQL after ICU stay in COVID-19 patients compared with patients admitted to the ICU before the pandemic.

Methods: A single center cohort study included all adult patients admitted to the ICU at a tertiary care hospital in Stockholm, Sweden due to acute COVID-19 infection during 2020–2021 with HRQL data at 4-9 months after ICU discharge. For comparison, patients admitted to the ICU for a minimum of 72 hours during 2018-2019 with HRQL data at 6 months post-ICU were included. HRQL was assessed with the RAND-36 questionnaire. Linear regression was performed to assess the differences in RAND-36 scores between groups, also adjusting for potential confounders.

Results: The study included a total of 164 COVID-19 patients and 105 non-COVID-19 patients. COVID-19 patients were younger, had lower Simplified Acute Physiological Score 3 scores and longer duration of mechanical ventilation, with a smaller proportion receiving mechanical ventilation. There were no statistically significant differences in reported HRQL post-ICU between the groups, after adjusting for confounders.

Conclusion: HRQL did not differ between ICU patients admitted before and during the pandemic. The impact of circumstances during the pandemic may have been less significant than expected. Identification and follow-up of post-ICU symptoms is relevant for ICU survivors irrespective of the initial diagnosis.