Top

Published in:

Open Access 01-12-2021 | Post-Traumatic Stress Disorder | Review

Management of COVID-19 ICU-survivors in primary care: - a narrative review

Authors: KFR Schmidt, J. Gensichen, S. Gehrke-Beck, R. P. Kosilek, F. Kühne, C Heintze, L. M. Baldwin, D. M. Needham

Published in: BMC Primary Care | Issue 1/2021

Abstract

Many survivors of critical illness suffer from long-lasting physical, cognitive, and mental health sequelae. The number of affected patients is expected to markedly increase due to the COVID-19 pandemic. Many ICU survivors receive long-term care from a primary care physician. Hence, awareness and appropriate management of these sequelae is crucial. An interdisciplinary authorship team participated in a narrative literature review to identify key issues in managing COVID-19 ICU-survivors in primary care. The aim of this perspective paper is to synthesize important literature to understand and manage sequelae of critical illness due to COVID-19 in the primary care setting.

Needham DM, Davidson J, Cohen H, Hopkins RO, Weinert C, Wunsch H, et al. Improving long-term outcomes after discharge from intensive care unit: report from a stakeholders' conference. Crit Care Med. 2012;40(2):502–9. https://doi.org/10.1097/CCM.0b013e318232da75.CrossRefPubMed

Thornton J. Covid-19: the challenge of patient rehabilitation after intensive care. BMJ. 2020;369:m1787.CrossRef

FICM Position Statement and Provisional Guidance: Recovery and Rehabilitation for Patients Following the Pandemic [https://www.ficm.ac.uk/news-events-education/news/provisional-guidance-recovery-and-rehabilitation-patients-following/].

Blankenfeld Hea: Neues Coronavirus (SARS-CoV-2)–Informationen für die hausärztliche Praxis. In: Guidelines of the German College of General Practitioners and Family Physicians vol. Version 14 2020: 053–054.

Korupolu R, Francisco G, Levin H, Needham D. Rehabilitation of critically ill COVID-19 survivors. J Int Soc Phys Rehabil Med. 2020;3(2):45–52. https://doi.org/10.4103/jisprm.jisprm_8_20.CrossRef

Needham DM, Sepulveda KA, Dinglas VD, Chessare CM, Friedman LA, Bingham CO III, et al. Core outcome measures for clinical research in acute respiratory failure survivors. An international modified Delphi consensus study. Am J Respir Crit Care Med. 2017;196(9):1122–30. https://doi.org/10.1164/rccm.201702-0372OC.CrossRefPubMedPubMedCentral

Lilley H, Payne R, Fox D, Brown RJ, Fountain D. Systematic Vs. Non-systematic literature review methodology for publication in leading journals. Value Health. 2020;23:S614. https://doi.org/10.1016/j.jval.2020.08.1280.CrossRef

Schofield-Robinson OJ, Lewis SR, Smith AF, McPeake J, Alderson P. Follow-up services for improving long-term outcomes in intensive care unit (ICU) survivors. Cochrane Database Syst Rev. 2018;11:Cd012701.PubMed

Rehabilitation after critical illness in adults [https://www.nice.org.uk/guidance/cg83].

10.

Hoffman K, Thomas A, Brett S. Clinical Pathways for the Continuum of Rehabilitation. In: Stevens RD, Hart N, editors. Textbook of post-ICU medicine: the legacy of critical care, Oxford University Press. Herridge: MS; 2014. p. 546–58.

11.

Ali NA, O'Brien JM Jr, Hoffmann SP, Phillips G, Garland A, et al. Acquired weakness, handgrip strength, and mortality in critically ill patients. Am J Respir Crit Care Med. 2008;178(3):261–8. https://doi.org/10.1164/rccm.200712-1829OC.CrossRefPubMed

12.

Paternostro-Sluga T, Grim-Stieger M, Posch M, Schuhfried O, Vacariu G, Mittermaier C, et al. Reliability and validity of the Medical Research Council (MRC) scale and a modified scale for testing muscle strength in patients with radial palsy. J Rehabil Med. 2008;40(8):665–71. https://doi.org/10.2340/16501977-0235.CrossRefPubMed

13.

Ambrose A, Bartels M, Verghese T, Verghese J. Patient and caregiver guide to managing COVID-19 patients at home. J Int Soc Phys Rehabil Med. 2020;3(2):53–68. https://doi.org/10.4103/jisprm.jisprm_4_20.CrossRef

14.

Parry SM, Nalamalapu SR, Nunna K, Rabiee A, Needham DM, et al. Six-minute walk distance after critical illness: a systematic review and meta-analysis. J Intensive Care Med. 2021;36(3):343–51. https://doi.org/10.1177/0885066619885838.

15.

Chan KS, Aronson Friedman L, Dinglas VD, Hough CL, Morris PE, Mendez-Tellez PA, et al. Evaluating physical outcomes in acute respiratory distress syndrome survivors: validity, responsiveness, and minimal important difference of 4-meter gait speed test. Crit Care Med. 2016;44(5):859–68. https://doi.org/10.1097/CCM.0000000000001760.CrossRefPubMedPubMedCentral

16.

Ohtake PJ, Lee AC, Scott JC, Hinman RS, Ali NA, Hinkson CR, et al. Physical impairments associated with post-intensive care syndrome: systematic review based on the World Health Organization's international classification of functioning, Disability and Health Framework. Phys Ther. 2018;98(8):631–45. https://doi.org/10.1093/ptj/pzy059.CrossRefPubMed

17.

Brodsky MB, Nollet JL, Spronk PE, Gonzalez-Fernandez M. Prevalence, Pathophysiology, Diagnostic Modalities and Treatment Options for Dysphagia in Critically Ill Patients. Am J Phys Med Rehabil. 2020;99:1164–70.CrossRef

18.

Snaith R, Zigmond A. Hospital anxiety and depression scale (HADS). In: Handbook of psychiatric measures. Washington: American Psychiatric Association; 2000. p. 547–8.

19.

Kroenke K, Spitzer RL, Williams JB, Monahan PO, Löwe B. Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med. 2007;146(5):317–25. https://doi.org/10.7326/0003-4819-146-5-200703060-00004.CrossRefPubMed

20.

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Arlington; 2013.

21.

Rabiee A, Nikayin S, Hashem MD, Huang M, Dinglas VD, Bienvenu OJ, et al. Depressive symptoms after critical illness: a systematic review and meta-analysis. Crit Care Med. 2016;44(9):1744–53. https://doi.org/10.1097/CCM.0000000000001811.CrossRefPubMedPubMedCentral

22.

Norman SB, Cissell SH, Means-Christensen AJ, Stein MB. Development and validation of an overall anxiety severity and impairment scale (OASIS). Depress Anxiety. 2006;23(4):245–9. https://doi.org/10.1002/da.20182.CrossRefPubMed

23.

Plummer F, Manea L, Trepel D, McMillan D. Screening for anxiety disorders with the GAD-7 and GAD-2: a systematic review and diagnostic metaanalysis. Gen Hosp Psychiatry. 2016;39:24–31. https://doi.org/10.1016/j.genhosppsych.2015.11.005.CrossRefPubMed

24.

Nikayin S, Rabiee A, Hashem MD, Huang M, Bienvenu OJ, Turnbull AE, et al. Anxiety symptoms in survivors of critical illness: a systematic review and meta-analysis. Gen Hosp Psychiatry. 2016;43:23–9. https://doi.org/10.1016/j.genhosppsych.2016.08.005.CrossRefPubMedPubMedCentral

25.

Hosey MM, Leoutsakos JS, Li X, Dinglas VD, Bienvenu OJ, et al. Screening for posttraumatic stress disorder in ARDS survivors: validation of the impact of event Scale-6 (IES-6). Crit Care. 2019;23(1):276. https://doi.org/10.1186/s13054-019-2553-z.CrossRefPubMedPubMedCentral

26.

Stoll C, Kapfhammer HP, Rothenhäusler HB, Haller M, Briegel J, Schmidt M, et al. Sensitivity and specificity of a screening test to document traumatic experiences and to diagnose post-traumatic stress disorder in ARDS patients after intensive care treatment. Intensive Care Med. 1999;25(7):697–704. https://doi.org/10.1007/s001340050932.CrossRefPubMed

27.

Schmidt KF, Schwarzkopf D, Baldwin LM, Brunkhorst FM, Freytag A et al: Long-Term Courses of Sepsis Survivors: Effects of a Primary Care Management Intervention. Am J Med 2020, 133(3): 381–385.e385.

28.

Nasreddine ZS, Phillips NA, Bedirian V, Charbonneau S, Whitehead V, et al. The Montreal cognitive assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53(4):695–9. https://doi.org/10.1111/j.1532-5415.2005.53221.x.CrossRefPubMed

29.

Mikkelsen ME, Still M, Anderson BJ, Bienvenu OJ, Brodsky MB, Brummel N, et al. Society of Critical Care Medicine's international consensus conference on prediction and identification of long-term impairments after critical illness. Crit Care Med. 2020;48(11):1670–9. https://doi.org/10.1097/CCM.0000000000004586.CrossRefPubMed

30.

Mikkelsen ME, Netzer G, Iwashyna T: Post-intensive care syndrome (PICS). In: edn. Edited by Post T. UpToDate; Waltham. (Accessed on June 16, 2020); 2020: 1–29.

31.

Desai SV, Law TJ, Needham DM. Long-term complications of critical care. Crit Care Med. 2011;39(2):371–9. https://doi.org/10.1097/CCM.0b013e3181fd66e5.CrossRefPubMed

32.

Schmidt KFR, Gehrke-Beck S: Transitions to primary care. In: Improving Critical Care Survivorship. Editors: Haines KJ, McPeake J, Sevin CM. Springer Nature 2021.

33.

Smith EMT, Lee ACW, Smith JM, Thiele A, Zeleznik H et al.: COVID-19 and post-intensive care syndrome: community-based care for ICU survivors. Home Health Care Manag Pract 2020, 0(0):1084822320974956.

34.

Jolley SE, Bunnell AE, Hough CL. ICU-acquired weakness. Chest. 2016;150(5):1129–40. https://doi.org/10.1016/j.chest.2016.03.045.CrossRefPubMedPubMedCentral

35.

Herridge MS, Tansey CM, Matte A, Tomlinson G, Diaz-Granados N, et al. Functional disability 5 years after acute respiratory distress syndrome. N Engl J Med. 2011;364(14):1293–304. https://doi.org/10.1056/NEJMoa1011802.CrossRefPubMed

36.

Liu K, Zhang W, Yang Y, Zhang J, Li Y, Chen Y. Respiratory rehabilitation in elderly patients with COVID-19: a randomized controlled study. Complement Ther Clin Pract. 2020;39:101166. https://doi.org/10.1016/j.ctcp.2020.101166.CrossRefPubMedPubMedCentral

37.

Wade D, Hardy R, Howell D, Mythen M. Identifying clinical and acute psychological risk factors for PTSD after critical care: a systematic review. Minerva Anestesiol. 2013;79(8):944–63.PubMed

38.

Biehl M, Sese D. Post-intensive care syndrome and COVID-19 - implications post pandemic. Cleve Clin J Med. 2020. https://doi.org/10.3949/ccjm.87a.ccc055.

39.

Bo HX, Li W, Yang Y, Wang Y, Zhang Q, et al. Posttraumatic stress symptoms and attitude toward crisis mental health services among clinically stable patients with COVID-19 in China. Psychol Med. 2020:1–2.

40.

DePierro J, Lowe S, Katz C. Lessons learned from 9/11: mental health perspectives on the COVID-19 pandemic. Psychiatry Res. 2020;288:113024. https://doi.org/10.1016/j.psychres.2020.113024.CrossRefPubMedPubMedCentral

41.

Taylor AK, Fothergill C, Chew-Graham CA, Patel S, Krige A. Identification of post-traumatic stress disorder following ICU. Br J Gen Pract. 2019;69(680):154–5. https://doi.org/10.3399/bjgp19X701765.CrossRefPubMedPubMedCentral

42.

Stam HJ, Stucki G, Bickenbach J. Covid-19 and Post Intensive Care Syndrome: A Call for Action. J Rehabil Med. 2020;52(4):jrm00044.CrossRef

43.

Murray H, Grey N, Wild J, Warnock-Parkes E, Kerr A, Clark DM, et al. Cognitive therapy for post-traumatic stress disorder following critical illness and intensive care unit admission. Cogn Behav Ther. 2020;13. https://doi.org/10.1017/S1754470X2000015X.

44.

Hopkins RO, Weaver LK, Pope D, Orme JF, Bigler ED, et al. Neuropsychological sequelae and impaired health status in survivors of severe acute respiratory distress syndrome. Am J Respir Crit Care Med. 1999;160(1):50–6. https://doi.org/10.1164/ajrccm.160.1.9708059.CrossRefPubMed

45.

Schmidt M, Azoulay E. Having a loved one in the ICU: the forgotten family. Curr Opin Crit Care. 2012;18(5):540–7. https://doi.org/10.1097/MCC.0b013e328357f141.CrossRefPubMed

46.

Kiernan F. Care of ICU survivors in the community: a guide for GPs. Br J Gen Pract. 2017;67(663):477–8. https://doi.org/10.3399/bjgp17X693029.CrossRefPubMedPubMedCentral

47.

Kamdar BB, Suri R, Suchyta MR, Digrande KF, Sherwood KD, Colantuoni E, et al. Return to work after critical illness: a systematic review and meta-analysis. Thorax. 2020;75(1):17–27. https://doi.org/10.1136/thoraxjnl-2019-213803.CrossRefPubMed

48.

Parker AM, Nelliot A, Chessare CM, Malik AM, Koneru M, Hosey MM, et al. Usability and acceptability of a mobile application prototype for a combined behavioural activation and physical rehabilitation intervention in acute respiratory failure survivors. Aust Crit Care. 2020;33(6):511–7. https://doi.org/10.1016/j.aucc.2020.02.010.CrossRefPubMed

49.

Cox CE, Porter LS, Hough CL, White DB, Kahn JM, Carson SS, et al. Development and preliminary evaluation of a telephone-based coping skills training intervention for survivors of acute lung injury and their informal caregivers. Intensive Care Med. 2012;38(8):1289–97. https://doi.org/10.1007/s00134-012-2567-3.CrossRefPubMedPubMedCentral

50.

Greenhalgh T, Knight M, A'Court C, Buxton M, Husain L. Management of post-acute covid-19 in primary care. BMJ. 2020;370:m3026.CrossRef

51.

Harvey MA, Davidson JE. Postintensive Care Syndrome: Right Care, Right Now … and Later. Crit Care Med. 2016;44(2):381–5. https://doi.org/10.1097/CCM.0000000000001531.CrossRefPubMed

52.

Tingey JL, Bentley JA, Hosey MM. COVID-19: understanding and mitigating trauma in ICU survivors. Psychol Trauma. 2020;12(S1):S100–4. https://doi.org/10.1037/tra0000884.CrossRefPubMed

Title: Management of COVID-19 ICU-survivors in primary care: - a narrative review
Authors: KFR Schmidt
J. Gensichen
S. Gehrke-Beck
R. P. Kosilek
F. Kühne
C Heintze
L. M. Baldwin
D. M. Needham
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Post-Traumatic Stress Disorder
Care
COVID-19
Post-Intensive Care Syndrome
Published in: BMC Primary Care / Issue 1/2021
Electronic ISSN: 2731-4553
DOI: https://doi.org/10.1186/s12875-021-01464-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Management of COVID-19 ICU-survivors in primary care: - a narrative review

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2021

A mixed-methods study describing behavioral factors that influenced general practitioners’ experiences using triage during the COVID-19 pandemic

First contact of care for persons with spinal cord injury: a general practitioner or a spinal cord injury specialist?

Clinical laboratory services for primary healthcare centers in urban cities: a pilot ACO model of ten primary healthcare centers

How do contraindications to non-opioid analgesics and opioids affect the likelihood that patients with back pain diagnoses in the primary care setting receive an opioid prescription? An observational cross-sectional study

Acceptability of physician associate interns in primary care: results from a service evaluation

What role conceptions do multi-healthcare professionals have of physicians and what role expectation do they have of physicians in a community?