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Long-term outcomes in critically ill patients who survived COVID-19: The NUTRICOVID observational cohort study

2023; Elsevier BV; Volume: 42; Issue: 10 Linguagem: Inglês

10.1016/j.clnu.2023.08.008

1532-1983

J. Álvarez-Hernández, Pilar Matía-Martín, E. Cáncer-Minchot, Cristina Cuerda, I. Sánchez López, C. Martínez, Cristina Aguilera, C. Velasco, V. Cevallos Peñafiel, M. Maíz Jiménez, Asunción Moreno, V. González-Sánchez, A. Ramos Carrasco, Juana Olivar Roldán, Silmary Maichle, Begoña Molina Baena, Samara Palma Milla, Inova Campos-Galicia, Naiara Modroño Móstoles, M. Blanca Martínez-Barbeito, L. Mola Reyes, María Merino Viveros, L. Arhip, Denys Leandro Viana Garcia, M. Huelves Delgado, Irene Gonzalo Montesinos, Beatriz Pelegrina-Cortés, Patricia Díaz Guardiola, Clara Marcuello, M.A. Sampedro-Núñez, Emilio Mantero Atienza, I. Hoyas Rodríguez, Mercedes Ramírez Ortiz, Antonio Morales, MaA Valero Zanuy, Maria J. Esteban, Carol Knott, A.E. Ortiz-Flores, MaP. Gómez Montes, M. Ruiz Aguado, Teresa Montoya Álvarez, Eric S. Martinez, A. Amengual Galbarte, Marta Rodríguez De Codesal, Belén Quesada Bellver, Francisco Javier Pérez‐Sádaba, Luís Lizán,

Intensive Care Unit Cognitive Disorders

Malnutrition and sarcopenia may last beyond hospital discharge, especially in patients admitted to intensive care units (ICU), having a negative impact on patient recovery and leading to disability, poor quality of life, and additional morbidity. No prior evidence is available for post-ICU management and follow-up of coronavirus disease 2019 (COVID-19) patients and their long-term evolution. This study reports on the one-year-long evolution of a cohort of COVID-19 survivors after ICU discharge, in terms of nutritional and functional status as well as health-related quality of life (HRQoL).A multicenter, ambispective, observational cohort study (NUTRICOVID study) was conducted in 16 public hospitals located in the Community of Madrid with COVID-19 survivors who were admitted to ICU during the first outbreak. Retrospective and prospective data were collected from hospital admission to one year after discharge. At hospital discharge and at 3, 6 and 12 months post-discharge, the following outcomes were recorded: weight, risk of malnutrition (MUST) and sarcopenia (SARC-F), medical nutrition therapy (MNT), functional status (Barthel index), and HRQoL (EQ-5D-5L).A total of 199 patients (70.4% male, mean age [SD] of 60.7 [10.1]) were included in the study. At hospital discharge, mean weight loss was 16.4% (8.0%), whereas most patients gained weight after discharge with an increase of 16.5% (14.0%) at 12 months. The proportion of patients at high risk of malnutrition decreased from 83.2% at hospital discharge to 2.1% at 12 months. The proportion at risk of sarcopenia decreased from 86.9% at hospital discharge to 13.4% at 12 months. At hospital discharge, 69 patients received MNT by means of oral nutritional supplements (ONS) while two patients required enteral nutrition (EN). At 12 months, only 12 patients continued taking ONS, with no patients taking EN. Regarding functional status, 72.9% of patients were moderately or severely dependent at hospital discharge, whereas 87.2% showed low dependency or independency after 12 months. The EQ-VAS values increased from hospital discharge (39 [21.2]) to 6 months post-discharge and remained steady up to 12 months (72.7 [19.0]). The mean health value improved from hospital discharge (0.25 [0.41]) to 6 months post-discharge (0.80 [0.24]) and was maintained thereafter.Patients' nutritional and functional impairment at hospital discharge was high, with high dependency status and low HRQoL; however, their situation improved progressively during the 12 months following hospital discharge. Nevertheless, there is a need to define early strategies to optimize the nutritional and functional recovery of COVID-19 patients.