Evaluation of Psychosomatic, Respiratory, and Neurocognitive Health in COVID-19 Survivors 12 Months after ICU Discharge

Author:

Germann Nicolas1,Amozova Daria2,Göhl-Freyn Kristina3,Fischer Tim4,Frischknecht Manuel5,Kleger Gian-Reto6,Pietsch Urs6ORCID,Filipovic Miodrag7,Brutsche Martin H.8ORCID,Frauenfelder Thomas9ORCID,Kahlert Christian R.510ORCID,Schmid Dagmar A.1,Albrich Werner C.5ORCID

Affiliation:

1. Department of Psychosomatic Medicine and Consultation-Liaison Psychiatry, Cantonal Hospital St. Gallen, 9007 St. Gallen, Switzerland

2. Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland

3. Department of Neurology, Cantonal Hospital St. Gallen, 9007 St. Gallen, Switzerland

4. Department of Radiology and Nuclear Medicine, Cantonal Hospital Winterthur, 8400 Winterthur, Switzerland

5. Division of Infectious Diseases, Infection Prevention and Travel Medicine, Cantonal Hospital St. Gallen, 9007 St. Gallen, Switzerland

6. Department of Intensive Care Medicine, Cantonal Hospital St. Gallen, 9007 St. Gallen, Switzerland

7. Division of Perioperative Intensive Care Medicine, Cantonal Hospital St. Gallen, 9007 St. Gallen, Switzerland

8. Department of Pulmonary and Sleep Medicine, Cantonal Hospital St. Gallen, 9007 St. Gallen, Switzerland

9. Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, 8091 Zurich, Switzerland

10. Infectious Diseases and Hospital Epidemiology, Children’s Hospital of Eastern Switzerland, 9007 St. Gallen, Switzerland

Abstract

Patients who survive critical COVID-19 frequently report post-acute sequelae of COVID-19 (PASC) such as psychosomatic and neurocognitive health problems. The goal of this study was to identify clinical risk factors and other predictors for such long-term consequences in severely ill COVID-19 patients. Adult COVID-19 intensive care unit (ICU) survivors from August 2020 to May 2021 were enrolled. A broad range of clinical, laboratory and chest computed tomography (CT) data was collected during their ICU stays. The association between ICU predictors and psychosomatic, respiratory, and neurocognitive assessments 12 months after ICU discharge was analyzed using univariate regression analysis. In 17 patients (mean age 58.9 ± 11.4 years), laboratory markers (CRP, lymphocytes, hemoglobin), ICU severity (SOFA, SAPS II, need for mechanical ventilation), complications (ARDS), and lung CT data (ground-glass opacity) were promising predictors of depressive and anxiety symptoms, fatigue, and sleep problems. Recovery of psychosomatic health such as fatigue, depression, and anxiety correlated with lower levels of inflammation and high hemoglobin levels. ARDS, mechanical ventilation, and worse SOFA and SAPS II scores were further risk factors for depressive and anxiety symptoms. Our study identified novel associations such as pulmonary ground-glass opacity being positively associated with depression, anxiety, fatigue, and insomnia levels.

Funder

Cantonal Hospital St. Gallen

Publisher

MDPI AG

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