Health-related quality of life in older patients surviving ICU treatment for COVID-19: results from an international observational study of patients older than 70 years
Authors: Soliman Ivo W , Leaver Susannah , Flaatten Hans , Fjølner Jesper , Wernly Bernhard , Bruno Raphael R , Artigas Antonio , Bollen Pinto Bernardo , Schefold Joerg C , Beil Michael , Sviri Sigal , van Heerden Peter Vernon , Szczeklik Wojciech , Elhadi Muhammed , Joannidis Michael , Oeyen Sandra , Zafeiridis Tilemachos , Wollborn Jakob , Banzo Maria Jose Arche , Fuest Kristina , Marsh Brian , Andersen Finn H , Moreno Rui , Boumendil Ariane , Guidet Bertrand , Jung Christian , De Lange Dylan W ,   The COVIP-study group, Eller Philipp , Joannidis Michael , Mesotten Dieter , Reper Pascal , Oeyen Sandra , Swinnen Walter , Brix Helene , Brushoej Jens , Villefrance Maja , Nedergaard Helene Korvenius , Bjerregaard Anders Thais , Balleby Ida Riise , Andersen Kasper , Hansen Maria Aagaard , Uhrenholt Stine , Bundgaard Helle , Fjølner Jesper , Mohamed Aliae Ar Hussein , Salah Rehab , Ali Yasmin Khairy NasrEldin Mohamed , Wassim Kyrillos , Elgazzar Yumna A , Tharwat Samar , Azzam Ahmed Y , Habib Ayman Abdelmawgoad , Abosheaishaa Hazem Maarouf , Azab Mohammed A , Leaver Susannah , Galbois Arnaud , Guidet Bertrand , Charron Cyril , Guerot Emmanuel , Besch Guillaume , Rigaud Jean-Philippe , Maizel Julien , Djibré Michel , Burtin Philippe , Garcon Pierre , Nseir Saad , Valette Xavier , Alexandru Nica , Marin Nathalie , Vaissiere Marie , Plantefeve Gaëtan , Vanderlinden Thierry , Jurcisin Igor , Megarbane Bruno , Caillard Anais , Valent Arnaud , Garnier Marc , Besset Sebastien , Oziel Johanna , Raphaelen Jean-Herlé , Dauger Stéphane , Dumas Guillaume , Goncalves Bruno , Piton Gaël , Jung Christian , Bruno Raphael Romano , Kelm Malte , Wolff Georg , Barth Eberhard , Goebel Ulrich , Barth Eberhard , Kunstein Anselm , Schuster Michael , Welte Martin , Lutz Matthias , Meybohm Patrick , Steiner Stephan , Poerner Tudor , Haake Hendrik , Schaller Stefan , Kindgen-Milles Detlef , Meyer Christian , Kurt Muhammed , Kuhn Karl Friedrich , Randerath Winfried , Wollborn Jakob , Dindane Zouhir , Kabitz Hans-Joachim , Voigt Ingo , Shala Gonxhe , Faltlhauser Andreas , Rovina Nikoletta , Aidoni Zoi , Chrisanthopoulou Evangelia , Papadogoulas Antonios , Gurjar Mohan , Mahmoodpoor Ata , Ahmed Abdullah Khudhur , Marsh Brian , Elsaka Ahmed , Sviri Sigal , Comellini Vittoria , Rabha Ahmed , Ahmed Hazem , Namendys-Silva Silvio A , Ghannam Abdelilah , Groenendijk Martijn , Zegers Marieke , de Lange Dylan , Cornet Alex , Evers Mirjam , Haas Lenneke , Dormans Tom , Dieperink Willem , Romundstad Luis , Sjøbø Britt , Andersen Finn H , Strietzel Hans Frank , Olasveengen Theresa , Hahn Michael , Czuczwar Miroslaw , Gawda Ryszard , Klimkiewicz Jakub , de LurdesSantos Maria Campos , Gordinho André , Santos Henrique , Assis Rui , Oliveira Ana Isabel Pinho , Badawy Mohamed Raafat , Perez-Torres David , Gomà Gemma , Villamayor Mercedes Ibarz , Mira Angela Prado , Cubero Patricia Jimeno , Rivera Susana Arias , Tomasa Teresa , Iglesias David , Vázquez Eric Mayor , Aldecoa Cesar , Ferreira Aida Fernández , Zalba-Etayo Begoña , Canas-Perez Isabel , Tamayo-Lomas Luis , Diaz-Rodriguez Cristina , Sancho Susana , Priego Jesús , Abualqumboz Enas M Y , Hilles Momin Majed Yousuf , Saleh Mahmoud , Ben-HAmouda Nawfel , Roberti Andrea , Dullenkopf Alexander , Fleury Yvan , Pinto Bernardo Bollen , Schefold Joerg C , Al-Sadawi Mohammed , Serck Nicolas , Dewaele Elisabeth , Kumar Pritpal , Bundesen Camilla , Innes Richard , Gooch James , Cagova Lenka , Potter Elizabeth , Reay Michael , Davey Miriam , Humphreys Sally , Berlemont Caroline Hauw , Chousterman Benjamin Glenn , Dépret François , Ferre Alexis , Vettoretti Lucie , Thevenin Didier , Faltlhauser Andreas , Milovanovic Milena , Simon Philipp , Lorenz Marco , Stoll Sandra Emily , Dubler Simon , Fuest Kristina , Mulita Francesk , Kondili Eumorifa , Andrianopoulos Ioannis , Meynaar Iwan , Cornet Alexander Daniel , Sjøbøe Britt , Kluzik Anna , Zatorski Paweł , Drygalski Tomasz , Szczeklik Wojciech , Solek-Pastuszka Joanna , Onichimowski Dariusz , Stefaniak Jan , Stefanska-Wronka Karina , Zabul Ewa , Cardoso Filipe Sousa , Banzo Maria José Arche , Tomasa-Irriguible Teresa Maria , Mira Ángela Prado , Arias-Rivera Susana , Frutos-Vivar Fernando , Lopez-Cuenca Sonia , de Gopegui Pablo Ruiz , Abidi Nour , Chau Ivan , Pugh Richard , Smuts Sara 
Published: December 2021

Abstract

Background
health-related quality of life (HRQoL) is an important patient-centred outcome in patients surviving ICU admission for COVID-19. It is currently not clear which domains of the HRQoL are most affected.

Objective
to quantify HRQoL in order to identify areas of interventions.

Design
prospective observation study.

Setting
admissions to European ICUs between March 2020 and February 2021.

Subjects
patients aged 70 years or older admitted with COVID-19 disease.

Methods
collected determinants include SOFA-score, Clinical Frailty Scale (CFS), number and timing of ICU procedures and limitation of care, Katz Activities of Daily Living (ADL) dependence score. HRQoL was assessed at 3 months after ICU admission with the Euro-QoL-5D-5L questionnaire. An outcome of ≥4 on any of Euro-QoL-5D-5L domains was considered unfavourable.

Results
in total 3,140 patients from 14 European countries were included in this study. Three months after inclusion, 1,224 patients (39.0%) were alive and the EQ-5D-5L from was obtained. The CFS was associated with an increased odds ratio for an unfavourable HRQoL outcome after 3 months; OR 1.15 (95% confidence interval (CI): 0.71–1.87) for CFS 2 to OR 4.33 (95% CI: 1.57–11.9) for CFS ≧ 7. The Katz ADL was not statistically significantly associated with HRQoL after 3 months.

Conclusions
in critically ill old intensive care patients suffering from COVID-19, the CFS is associated with the subjectively perceived quality of life. The CFS on admission can be used to inform patients and relatives on the risk of an unfavourable qualitative outcome if such patients survive.