tetano
Editor, Senior Moderator
PLoS One
. 2026 Feb 18;21(2):e0341319.
doi: 10.1371/journal.pone.0341319. eCollection 2026.
Three-year functional, physical, and mental health outcomes after critical COVID-19: A prospective multicentre cohort study
Ingrid Didriksson[SUP] 1 2 [/SUP], Dorit Töniste[SUP] 3 4 [/SUP], Malin Hultgren[SUP] 1 [/SUP], Martin Spångfors[SUP] 1 5 [/SUP], Sara Göbel Andertun[SUP] 6 7 [/SUP], Maria Nelderup[SUP] 6 7 [/SUP], Anton Reepalu[SUP] 8 9 [/SUP], Attila Frigyesi[SUP] 1 10 [/SUP], Hans Friberg[SUP] 1 2 [/SUP], Gisela Lilja[SUP] 3 4 [/SUP]
Affiliations
Background: The understanding of recovery after critical COVID-19 beyond the first year is limited.
Objectives: To describe changes in functional, physical, and mental health outcomes between 1 and 3 years among survivors of critical COVID-19 and to identify factors associated with incomplete recovery at 3 years.
Methods: A prospective multicentre cohort study of survivors of critical COVID-19 with follow-up at 1 and 3 years. The primary outcome was functional outcome, assessed using the Glasgow Outcome Scale-Extended (GOSE), which ranges from 1 to 8, with scores of 6 or less indicating incomplete recovery. Secondary outcomes included return-to-work, physical and mental Health-Related Quality of Life (HRQoL), life satisfaction, fatigue, psychological symptoms (anxiety, depression, post-traumatic stress disorder), and respiratory symptoms. Multivariable logistic regression was used to identify factors associated with incomplete recovery (GOSE ≤ 6) at 3 years.
Results: Among 191 of 210 eligible participants, functional outcome declined from 1 to 3 years, and participants with incomplete recovery increased from 32% to 45%. Worse outcomes were observed in mental HRQoL, fatigue, depression, and post-traumatic stress, while return-to-work rates, physical HRQoL, life satisfaction, anxiety, and respiratory symptoms remained stable. Younger age [OR 0.70 (95% CI 0.54-0.91), p = 0.008] and higher Clinical Frailty Scale score [OR 1.54 (95% CI 1.04-2.28), p = 0.029] were independently associated with incomplete recovery at 3 years.
Conclusions: Survivors of critical COVID-19 experienced a decline in functional outcome and worsening mental health between 1 and 3 years after ICU admission. Younger and frail survivors may require increased attention and support.
Trial registration: ClinicalTrials.gov Identifier: NCT04974775, registered April 28, 2020.
. 2026 Feb 18;21(2):e0341319.
doi: 10.1371/journal.pone.0341319. eCollection 2026.
Three-year functional, physical, and mental health outcomes after critical COVID-19: A prospective multicentre cohort study
Ingrid Didriksson[SUP] 1 2 [/SUP], Dorit Töniste[SUP] 3 4 [/SUP], Malin Hultgren[SUP] 1 [/SUP], Martin Spångfors[SUP] 1 5 [/SUP], Sara Göbel Andertun[SUP] 6 7 [/SUP], Maria Nelderup[SUP] 6 7 [/SUP], Anton Reepalu[SUP] 8 9 [/SUP], Attila Frigyesi[SUP] 1 10 [/SUP], Hans Friberg[SUP] 1 2 [/SUP], Gisela Lilja[SUP] 3 4 [/SUP]
Affiliations
- PMID: 41706661
- DOI: 10.1371/journal.pone.0341319
Background: The understanding of recovery after critical COVID-19 beyond the first year is limited.
Objectives: To describe changes in functional, physical, and mental health outcomes between 1 and 3 years among survivors of critical COVID-19 and to identify factors associated with incomplete recovery at 3 years.
Methods: A prospective multicentre cohort study of survivors of critical COVID-19 with follow-up at 1 and 3 years. The primary outcome was functional outcome, assessed using the Glasgow Outcome Scale-Extended (GOSE), which ranges from 1 to 8, with scores of 6 or less indicating incomplete recovery. Secondary outcomes included return-to-work, physical and mental Health-Related Quality of Life (HRQoL), life satisfaction, fatigue, psychological symptoms (anxiety, depression, post-traumatic stress disorder), and respiratory symptoms. Multivariable logistic regression was used to identify factors associated with incomplete recovery (GOSE ≤ 6) at 3 years.
Results: Among 191 of 210 eligible participants, functional outcome declined from 1 to 3 years, and participants with incomplete recovery increased from 32% to 45%. Worse outcomes were observed in mental HRQoL, fatigue, depression, and post-traumatic stress, while return-to-work rates, physical HRQoL, life satisfaction, anxiety, and respiratory symptoms remained stable. Younger age [OR 0.70 (95% CI 0.54-0.91), p = 0.008] and higher Clinical Frailty Scale score [OR 1.54 (95% CI 1.04-2.28), p = 0.029] were independently associated with incomplete recovery at 3 years.
Conclusions: Survivors of critical COVID-19 experienced a decline in functional outcome and worsening mental health between 1 and 3 years after ICU admission. Younger and frail survivors may require increased attention and support.
Trial registration: ClinicalTrials.gov Identifier: NCT04974775, registered April 28, 2020.