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Canadian Journal of Anesthesia/Journal canadien d'anesthésie
Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie 5/2022

01-05-2022 | Acute Respiratory Distress-Syndrome | Review Article/Brief Review

Outcomes of critically ill COVID-19 survivors and caregivers: a case study-centred narrative review

Authors: Michelle E. Kho, PT, PhD, Oleksa G. Rewa, MD, MSc, J. Gordon Boyd, MD, PhD, Karen Choong, MB, BCh, MSc, Graeme C. H. Stewart, BPAPM (c), Margaret S. Herridge, MS, MD, MPH

Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Issue 5/2022

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Abstract

Purpose

Critical illness is a transformative experience for both patients and their family members. For COVID-19 patients admitted to the intensive care unit (ICU), survival may be the start of a long road to recovery. Our knowledge of the post-ICU long-term sequelae of acute respiratory distress syndrome (ARDS) and severe acute respiratory syndrome (SARS) may inform our understanding and management of the long-term effects of COVID-19.

Source

We identified international and Canadian epidemiologic data on ICU admissions for COVID-19, COVID-19 pathophysiology, emerging ICU practice patterns, early reports of long-term outcomes, and federal support programs for survivors and their families. Centred around an illustrating case study, we applied relevant literature from ARDS and SARS to contextualize knowledge within emerging COVID-19 research and extrapolate findings to future long-term outcomes.

Principal findings

COVID-19 is a multisystem disease with unknown long-term morbidity and mortality. Its pathophysiology is distinct and unique from ARDS, SARS, and critical illness. Nevertheless, based on initial reports of critical care management for COVID-19 and the varied injurious supportive practices employed in the ICU, patients and families are at risk for post-intensive care syndrome. The distinct incremental risk of COVID-19 multiple organ dysfunction is unknown. The risk of mood disorders in family members may be further exacerbated by imposed isolation and stigma.

Conclusion

Emerging literature on COVID-19 outcomes suggests some similarities with those of ARDS/SARS and prolonged mechanical ventilation. The pathophysiology of COVID-19 is presented here in the context of early outcome data and to inform an agenda for longitudinal research for patients and families.
Footnotes
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Metadata
Title
Outcomes of critically ill COVID-19 survivors and caregivers: a case study-centred narrative review
Authors
Michelle E. Kho, PT, PhD
Oleksa G. Rewa, MD, MSc
J. Gordon Boyd, MD, PhD
Karen Choong, MB, BCh, MSc
Graeme C. H. Stewart, BPAPM (c)
Margaret S. Herridge, MS, MD, MPH
Publication date
01-05-2022
Publisher
Springer International Publishing
Published in
Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Issue 5/2022
Print ISSN: 0832-610X
Electronic ISSN: 1496-8975
DOI
https://doi.org/10.1007/s12630-022-02194-4

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