This is a summary, written by members of the CITF Secretariat, of:

Parotto M, Nainan MS, Munblit D, Elhazmi A, Ranzani O, Herridge M. Recovery after prolonged ICU treatment in patients with COVID-1. The Lancet Respiratory Medicine, Volume 9, Issue 8, 812 – 814 DOI: https://doi.org/10.1016/S2213-2600(21)00318-0

The results and/or conclusions contained in the research do not necessarily reflect the views of all CITF members.

A recent commentary in Lancet Respiratory Medicine by CITF-funded researcher Dr. Margaret Herridge and colleagues highlights the record volume of COVID-19 patients treated for prolonged periods in Intensive Care Units (ICUs) around the world. Previous experience and follow-up data pre-pandemic from survivors of acute respiratory distress syndrome and other coronavirus infections indicate that a large proportion of patients have physical and cognitive impairments for weeks, and even years. Some may even have permanent disabilities after ICU discharge. The authors argue there is an urgent need to better understand the wide spectrum of consequences post-critical COVID-19, as well as a need to prioritize patient-centered and family-centered interventions.

The authors state that the lack of post-COVID-19 long-term outcome data – as well as the lack of understanding of the direct consequences of COVID-19 – makes it challenging to provide optimal care after acute disease.

Key points:

  • Patients treated for prolonged periods in the ICU after an acute COVID-19 infection might experience a wide array of symptoms during their post-ICU recovery phase. These include persistent weakness, peripheral nerve injuries, joint contracture, injuries from intubation, and very commonly, substantial functional dependencies for daily activities, including getting around independently and caring for oneself.
  • Better understanding the spectrum of health consequences to the patients will – or should – allow the prioritization of patient-centred and family-centred interventions and the formulation of strategies to meet their post-ICU physical and mental health needs.
  • Patients and family caregivers can also develop important mental health challenges, lasting months to years after a loved one’s critical illness. These challenges might be exacerbated in a pandemic in which patients and families are isolated and stigmatized, and where racial and ethnic minorities might be disproportionately affected.
  • The scientific community needs to endorse the importance of following-up with patients and reporting long-term outcomes for the interventions that have now become the standard of care during the acute phase of SARS-CoV-2 infection.