Recovery from Covid-19 critical illness: a secondary analysis of the ISARIC4C CCP-UK cohort study and the RECOVER trial

ISARIC4C and RECOVER Investigators, Ellen Pauley, Thomas M Drake, David M Griffith, Nazir I Lone, Ewen M Harrison, J Kenneth Baillie, Janet T Scott, Timothy S Walsh, Malcolm G Semple, Annemarie B Docherty

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Background
We aimed to compare the prevalence and severity of fatigue in survivors of Covid-19 versus non-Covid-19 critical illness, and to explore potential associations between baseline characteristics and worse recovery.
Methods
We conducted a secondary analysis of two prospectively collected datasets. The population included was 92 patients who received invasive mechanical ventilation (IMV) with Covid-19, and 240 patients who received IMV with non-Covid-19 illness before the pandemic. Follow-up data was collected post-hospital discharge using self-reported questionnaires. The main outcome measures were self-reported fatigue severity and the prevalence of severe fatigue (severity >7/10) 3 and 12-months post-hospital discharge.
Results
Covid-19 IMV-patients were significantly younger with less prior comorbidity, and more males, than pre-pandemic IMV-patients. At 3-months, the prevalence (38.9% [7/18] vs. 27.1% [51/188]) and severity (median 5.5/10 vs. 5.0/10) of fatigue was similar between the Covid-19 and pre-pandemic populations respectively. At 6-months, the prevalence (10.3% [3/29] vs. 32.5% [54/166]) and severity (median 2.0/10 vs. 5.7/10) of fatigue was less in the Covid-19 cohort. In the Covid-19 population, women under 50 experienced more severe fatigue, breathlessness, and worse overall health state compared to other Covid-19 IMV-patients. There were no significant sex differences in long-term outcomes in the pre-pandemic population. In the total sample of IMV-patients included (i.e. all Covid-19 and pre-pandemic patients), having Covid-19 was significantly associated with less severe fatigue (severity <7/10) after adjusting for age, sex, and prior comorbidity (adjusted OR 0.35 (95%CI 0.15-0.76, p=0.01).
Conclusion
Fatigue may be less severe after Covid-19 than after other critical illness.
Original languageEnglish
Pages (from-to)162-169
Number of pages8
JournalJournal of the Intensive Care Society
Volume24
Issue number2
Early online date24 Oct 2021
DOIs
Publication statusPublished - 1 May 2023

Keywords / Materials (for Non-textual outputs)

  • COVID-19
  • SARS-CoV-2
  • critical care
  • critical illness
  • intensive care units

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