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Chest . Outcomes and Management following COVID-19 Critical Illness

tetano

Editor, Senior Moderator
Chest


. 2023 Dec 15:S0012-3692(23)05854-3.
doi: 10.1016/j.chest.2023.11.044. Online ahead of print. Outcomes and Management following COVID-19 Critical Illness

Leigh Cagino[SUP] 1 [/SUP], Katharine Seagly[SUP] 2 [/SUP], Emily Noyes[SUP] 3 [/SUP], Hallie Prescott[SUP] 4 [/SUP], Thomas Valley[SUP] 5 [/SUP], Tammy Eaton[SUP] 6 [/SUP], Jakob I McSparron[SUP] 7 [/SUP]



Affiliations
Abstract

Topic importance: Coronavirus disease 2019 (COVID-19) has caused over 7 million deaths worldwide since its onset in 2019. While the severity of illness has varied throughout the pandemic, critical illness related to COVID-19 persists. Survivors of COVID-19 critical illness can be left with sequalae of both the SARS-CoV-2 virus and long-term effects of critical illness included within post-intensive care unit syndrome. Given the complexity and heterogeneity of COVID-19 critical illness, the bio-psycho-social-ecological model can aid in evaluation and treatment of survivors, integrating interactions between physical, cognitive, and psychological domains, as well as social systems and environments.
Review findings: Prolonged illness following COVID-19 critical illness can generally be classified into effects on physical, cognitive and psychosocial function, with much interaction between the various effects, and includes a wide range of symptoms such as ICU-acquired weakness, prolonged respiratory symptoms, cognitive changes, PTSD, anxiety and depression. Risk factors for developing COVID-19 critical illness are complex, and include pre-existing factors, disease course, specifics of hospitalization in addition to psychological comorbidities and social-environmental factors. Recovery trajectories are not well defined and management requires a comprehensive, interdisciplinary and individualized approach to care.
Summary: The onset of vaccinations, new therapeutics and new strains the SARS-CoV-2 virus has decreased COVID-19 mortality; however, the number of COVID-19 critical illness survivors remains high. A bio-psycho-social-ecological approach is recommended to guide care of the post-COVID-19 critical illness survivor.


 
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