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Post-Intensive Care Syndrome Associated With Coronavirus Disease: A Single Institutional Study In Tokyo


 Background: The occurrence of post-intensive care syndrome (PICS) in critically ill patients with coronavirus disease (COVID-19) remains unclear. This study aimed to investigate the physical, mental, and cognitive components of PICS in intensive care unit (ICU)-treated COVID-19 survivors.Methods: This prospective cohort study enrolled patients with COVID-19 who were treated in the ICU of a single institution between March 19, 2020 and April 30, 2020. A survey was sent by postal mail at 4 and 6 months after ICU discharge. The questionnaire comprised the post-COVID-19 functional status (PCFS) scale and the modified medical research council dyspnea scale (mMRC) for assessing physical PICS; the impact of event scale-revised (IES-R) and the hospital anxiety and depression scale (HADS) for assessing mental PICS; and self-assessment questions for concentration, memory, and forgetfulness for assessing cognitive PICS. Physical PICS was defined by a PCFS or mMRC score ≥1. Mental PICS was defined by an IES-R score ≥25 or if the HADS score for anxiety or depression components was ≥8. Cognitive PICS was defined according to patient complaints of deterioration in concentration, memory, or forgetfulness. The primary outcome was PICS occurrence at 4 months. Moreover, we assessed the co-occurrence of the three PICS components.Results: Twenty patients consented to participate in the study and responded to the survey. The median age was 57.5 years, and 80% of the patients were male; moreover, 50%, 55%, and 80% lived alone, were married, and were employed/self-employed before hospitalization, respectively. During ICU stay, 80%, 75%, and 25% received invasive mechanical ventilation, systemic steroids, and continuous benzodiazepine, respectively. Delirium occurred in 40% of patients. The median days of ICU and hospital stay were 6 and 21, respectively. Physical, mental, and cognitive PICS occurred in 14 (78%), 9 (45%), and 11 (55%) patients, respectively. There were 16 (80%) and 8 (40%) patients with at least one and all PICS components, respectively.Conclusions: Our findings revealed a high rate of PICS in COVID-19 survivors. Long-term and comprehensive evaluation of all three PICS components is crucial for providing appropriate care to these patients.