Disability Following Critical Illness Due to COVID-19—Where to Next?

Advancements in intensive care have significantly increased ICU survivorship.¹ However, the landmark papers by Herridge et al² and Cuthbertson et al³ highlight that survivorship does not equate to recovery. This lack of recovery manifests as physical, cognitive, and psychological impairments that persist following ICU discharge. Collectively, these impairments are termed post–intensive care syndrome (PICS).⁴ The lasting impact PICS has on survivors of critical illness has prompted clinicians and researchers to report long-term follow-up using self-reported and performance-based outcomes⁵ in both observational and interventional trials.

Worldwide, the COVID-19 pandemic resulted in a rapid increase in the number of patients being admitted to ICU.⁶ During the pandemic, it emerged that some patients had long-term sequelae associated with COVID-19 infection, termed post–COVID-19 condition,⁷ that were similar to those observed in PICS.⁸ Understanding the impact of surviving COVID-19 critical illness and how it may differ from post–COVID-19 condition became a priority for clinicians, researchers, and policymakers.⁸

In the study by da Silva et al,⁹ published in this issue of Respiratory Care, the authors aimed to assess the disability associated with COVID-19 critical illness survivorship. They compared disability in subjects who received invasive mechanical ventilation with those that did not, at 3 and 6 months after hospital discharge in 2 university hospitals in São Paolo, Brazil. The primary outcome of disability was assessed using the 36-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). The WHODAS 2.0 classifies severity of disability according to total score, stratified into 5 categories. A …

Correspondence: Luke A McDonald PhD student, Department of Physiotherapy, Level 3, Harold Stokes Building, Austin Hospital, 145 Studley Road, Heidelberg, VIC, 3084, Australia. E-mail: luke.mcdonald{at}austin.org.au