SOFMER / SFAR / SRLF
Le 15/10/2021 de 13:30 à 15:30
Le syndrome post-réanimation, un fardeau pour les survivants 6 mois après une COVID grave.
Simon Butet (Rennes, France), Félicie Bélicard (Rennes, France), Jean-Marc Tadié (Rennes, France), Sébastien Cordillet (Rennes, France), Yoann Launey (Rennes, France), Mélanie Cogné (Rennes, France), Isabelle Bonan (Rennes, France)
Objective : COVID-19 is at risk of extensive ICU stay with ICU-acquired weakness (ICU-AW). In our study, we aimed to show that functional outcomes at 6 months after SARS-CoV-2 infection discharged from ICU depends on their care: discharge to Physical and Rehabilitation Medicine (PRM) versus discharged at home for independent patients.
Material / Patients and Methods : All COVID-19 patients hospitalized in ICU between March 1st 2020 and April 30st 2020 were included. Before discharge from ICU, patients were screened for PRM needs. According to the Functional Independence Measure (FIM), patients considered as dependent were admitted to the PRM unit (Group 1). If patients were assessed as sufficiently independent, they returned home (Group 2). We evaluated both groups at 6 months using the WHO Disability Assessment Schedule 12 items (WHODAS-12), the MRC dyspnea scale and 5 questions related to their psychological state.
Results : 74 patients were included. Five (6.7%) died during ICU stay. Two were transferred to another PRM facility (no data available). In total, 67 patients were included (Group 1: 36, Group 2: 31). The mean 6-month WHODAS-12 was 19.1±31 in Group 1 and 8.9±10.7 in Group 2, indicating a reduced level of participation’s restrictions across both groups. Notably, their health condition impacted their emotional state. Group 2 patients had greater difficulties returning to their previous mood state, and sleep difficulties i.e. psychological features of post-intensive care syndrome.
Discussion - Conclusion : Patients hospitalized in ICU because of COVID-19 require PRM care. Even physical recovery meets expectation, we should not underestimate the possibility of mental and cognitive post-intensive care syndrome.
Keywords : COVID, ICU, PRM
Disclosure of interest : Aucun