The impact of COVID-19 critical illness on new disability, functional outcomes and return to work at 6 months: a prospective cohort study
Authors: Hodgson Carol L. , Higgins Alisa M. , Bailey Michael J. , Mather Anne M. , Beach Lisa , Bellomo Rinaldo , Bissett Bernie , Boden Ianthe J. , Bradley Scott , Burrell Aidan , Cooper D. James , Fulcher Bentley J. , Haines Kimberley J. , Hopkins Jack , Jones Alice Y. M. , Lane Stuart , Lawrence Drew , van der Lee Lisa , Liacos Jennifer , Linke Natalie J. , Gomes Lonni Marques , Nickels Marc , Ntoumenopoulos George , Myles Paul S. , Patman Shane , Paton Michelle , Pound Gemma , Rai Sumeet , Rix Alana , Rollinson Thomas C. , Sivasuthan Janani , Tipping Claire J. , Thomas Peter , Trapani Tony , Udy Andrew A. , Whitehead Christina , Hodgson Isabelle T. , Anderson Shannah , Neto Ary Serpa ,   The COVID-Recovery Study Investigators and the ANZICS Clinical Trials Group, Burgess Nicola , Hearn Kirsty , Brewster David , Waanders Alyssa , Simpson Shannon , de Silva Yasmin , Lang Jenna , Burleigh Sarah , Killer Elisha , Wang Michael , O’Connor Lauren , Thomas Lauren , Dennis Lucy , Caruana Joanna , Al-Bassam Wisam , Shealy Morag , Chapman Marianne , O’Connor Stephanie , Sheehan Janne , Alexander Emily , Sukkar Amanda , Davis Liesl , Bass Francis , Hammond Naomi , O’Connor Anne , Yarad Elizabeth , Buhr Richard Totaro Heidi , Reddy Nazmeen , Chaseling Wendy , Ip Kelvin , Tronstad Oystein , Mahoney Alison , Fanning Cadi , Esterman Hariette , Kozary Alexia , Scott Bronte , Urquhart Donna 
Published: November 2021

Abstract
Background
There are few reports of new functional impairment following critical illness from COVID-19. We aimed to describe the incidence of death or new disability, functional impairment and changes in health-related quality of life of patients after COVID-19 critical illness at 6 months.

Methods
In a nationally representative, multicenter, prospective cohort study of COVID-19 critical illness, we determined the prevalence of death or new disability at 6 months, the primary outcome. We measured mortality, new disability and return to work with changes in the World Health Organization Disability Assessment Schedule 2.0 12L (WHODAS) and health status with the EQ5D-5LTM.

Results
Of 274 eligible patients, 212 were enrolled from 30 hospitals. The median age was 61 (51–70) years, and 124 (58.5%) patients were male. At 6 months, 43/160 (26.9%) patients died and 42/108 (38.9%) responding survivors reported new disability. Compared to pre-illness, the WHODAS percentage score worsened (mean difference (MD), 10.40% [95% CI 7.06–13.77]; p < 0.001). Thirteen (11.4%) survivors had not returned to work due to poor health. There was a decrease in the EQ-5D-5LTM utility score (MD, − 0.19 [− 0.28 to − 0.10]; p < 0.001). At 6 months, 82 of 115 (71.3%) patients reported persistent symptoms. The independent predictors of death or new disability were higher severity of illness and increased frailty.

Conclusions
At six months after COVID-19 critical illness, death and new disability was substantial. Over a third of survivors had new disability, which was widespread across all areas of functioning.
Clinical trial registrationNCT04401254 May 26, 2020.