Health-related quality of life of COVID-19 two and 12 months after intensive care unit admission

Abstract

Purpose: To describe health-related quality of life (HRQoL) and dyspnea of COVID-19, 2 and 12 months after an intensive care unit (ICU) stay. Methods: Patients discharged from the ICU between April and June 2020 and subsequently transferred to an inpatient rehabilitation facility were assessed 2 months and 12 months after ICU admission. HRQoL was assessed by the EuroQoL EQ-5D-3L (visual analog scale and time trade-off normalized to the French population algorithm) and dyspnea was assessed by the modified Medical Research Council (mMRC) dyspnea scale. Results: We enrolled 94 patients. Median EQ-5D-3L time trade-off was 0.80 (interquartile range, 0.36–0.91) at 2 months and 0.91 (0.52–1.00) at 12 months (P = 0.12). EQ-5D-3L visual analog scale was 70 (60–85) at 2 months and 70 (60–85) at 12 months (P = 0.07). The mMRC dyspnea scale was 3 (2–4) at ICU discharge, 1 (0–2), P < 0.001 at 2 months and 1 (1–2) at 12 months. At 12 months, 68 (76%) patients reported at least one symptom that was not present prior to ICU admission and 27 (61%) of the 44 patients who were previously working had returned to work. On multiple linear regression, factors associated with EQ-5D-3L were body mass index on ICU admission, tracheostomy, male gender and active smoking. Conclusions: Twelve months after ICU admission for COVID-19 and subsequent rehabilitation, a substantial proportion of patients reported alterations of HRQoL, dyspnea and symptoms that were not present prior to admission and a substantial proportion of these patients had not returned to work. Factors associated with a risk of poorer 12-month quality of life, may help to identify at-risk patients.