Prevalence, characteristics and longer-term outcomes of patients with persistent critical illness due to COVID-19 in Scotland: a national cohort study.

Michael C Blayney, Neil I Stewart, Callum T Kaye, Kathryn Puxty, Robert Chan Seem, Lorraine Donaldson, Catriona Haddow, Ros Hall, Caroline Martin, Martin Paton, Nazir I Lone*, Joanne McPeake

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Patients with COVID-19 can require critical care for prolonged periods. Patients with persistent critical Illness can have complex recovery trajectories, but this has not been studied for patients with COVID-19. We examined the prevalence, risk factors, and long-term outcomes of critically ill patients with COVID-19 and persistent critical illness.

Methods: This was a national cohort study of all adults admitted to Scottish critical care units with COVID-19 from March 1, 2020 to September 4, 20. Persistent critical illness was defined as a critical care length of stay (LOS) of ≥10 days. Outcomes included 1-yr mortality and hospital readmission after critical care discharge. Fine and Gray competing risk analysis was used to identify factors associated with persistent critical Illness with death as a competing risk.

Results: A total of 2236 patients with COVID-19 were admitted to critical care; 1045 patients were identified as developing persistent critical Illness, comprising 46.7% of the cohort but using 80.6% of bed-days. Patients with persistent critical illness used more organ support, had longer post-critical care LOS, and longer total hospital LOS. Persistent critical illness was not significantly associated with long-term mortality or hospital readmission. Risk factors associated with increased hazard of persistent critical illness included age, illness severity, organ support on admission, and fewer comorbidities.

Conclusions: Almost half of all patients with COVID-19 admitted to critical care developed persistent critical illness, with high resource use in critical care and beyond. However, persistent critical illness was not associated with significantly worse long-term outcomes compared with patients who were critically ill for shorter periods.
Original languageEnglish
Pages (from-to)980-989
JournalBritish Journal of Anaesthesia
Volume128
Issue number6
Early online date24 Mar 2022
DOIs
Publication statusPublished - 1 Jun 2022

Keywords

  • Adult
  • COVID-19/epidemiology
  • Cohort Studies
  • Critical Illness/epidemiology
  • Hospital Mortality
  • Humans
  • Intensive Care Units
  • Length of Stay
  • Prevalence
  • Retrospective Studies

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