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

Blayney, M. C. et al. (2022) Prevalence, characteristics and longer-term outcomes of patients with persistent critical illness due to COVID-19 in Scotland: a national cohort study. British Journal of Anaesthesia, 128(6), pp. 980-989. (doi: 10.1016/j.bja.2022.03.017) (PMID:35465954) (PMCID:PMC8942655)

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Abstract

Background: Patients with coronavirus disease (COVID-19) can require critical care for prolonged periods. Patients with Persistent Critical Illness can have complex recovery trajectories but this has not been researched for patients with COVID-19. We examined the prevalence, risk factors and long-term outcomes of critically ill COVID-19 patients with persistent critical illness. Methods: A national cohort study of all adults admitted to Scottish critical care units with COVID-19 from 01/03/20 to 04/09/21. Persistent critical illness was defined as a critical care length of stay (LOS) of ≥10 days. Outcomes included one-year mortality and hospital readmission following 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: 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. Persistent Critical Illness patients 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 include age, illness severity, organ support on admission and fewer comorbidities. Conclusion: Almost half of all critical care patients with COVID-19 develop persistent critical illness, with high resource use in critical care and beyond. However, persistent critical illness was not associated with a significantly worse long-term outcomes compared to patients who were critically ill for shorter periods.

Item Type:Articles
Keywords:COVID-19, intensive care, long-term ventilation, mortality, readmission.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:McPeake, Dr Jo and Puxty, Dr Kathryn
Authors: Blayney, M. C., Stewart, N. I., Kaye, C. T., Puxty, K., Chan Seem, R., Donaldson, L., Haddow, C., Hall, R., Martin, C., Paton, M., Lone, N. I., and McPeake, J.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Nursing and Health Care
Journal Name:British Journal of Anaesthesia
Publisher:Elsevier
ISSN:0007-0912
ISSN (Online):1471-6771
Published Online:24 March 2022
Copyright Holders:Copyright © 2022 British Journal of Anaesthesia
First Published:First published in British Journal of Anaesthesia 128(6): 980-989
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
307748Improving health and social care integration delivery in the acute care environmentJoanne McPeakeUniversity of Cambridge (HEI-CAMB)RG88620HW - MRC/CSO Social and Public Health Sciences Unit