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Post Intensive Care Syndrome in the Aftermath of Covid-19

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Post Intensive Care Syndrome in the Aftermath of Covid-19 29 October 2020 COVID 19 – KCE CONTRIBUTIONS POST INTENSIVE CARE SYNDROME IN THE AFTERMATH OF COVID-19 GERMAINE HANQUET, NADIA BENAHMED, DIEGO CASTANARES-ZAPATERO, MARIE DAUVRIN, ANJA DESOMER, JEF ADRIAENSSENS, KARIN RONDIA This document is a rapid review of scientific literature retrieved from several publicly funded COVID-19 resource collections. The literature included in these repositories is not always peer-reviewed or externally validated. KCE synthesised the evidence in short time frames to respond to urgent questions and could therefore not follow its regular methodological procedures. This work is used to inform guidance of other governmental agencies (like Sciensano, CSS/HGR, AFMPS/FAGG and SPF/FOD). Version 29/10/2020 15:09 2 ACKNOWLEDGEMENTS: We thank the following experts for the revision of the report or of a part of the report: Sandra Oeyen (UZ Gent) – Bert Aertgeerts (KULeuven) – Nicolas Delvaux (KULeuven) – Carlotte Kiekens (UZLeuven) – Geert Verscuren, Céline Franken, Valérie De Meue Patriek Verliefde, Yves Paulus (INAMI-RIZIV) – Eric Salmon (CHU de Liège). We thank the following experts for their contribution for the content of the report: Hervé Avalosse (Mutualités Chrétiennes) – Céline Barbier – Chloé Blasson (Cliniques Universitaires Saint-Luc) – Annabel Boury (UZ Intens) – Arnaud Bruyneel (SIZ Nursing/Soins intensifs CHU Tivoli) – Annemarie Büttner (Charité Universitätsmedizin Berlin) – Begonia Cainas (CHU Saint Pierre – UMC Sint Pieter) – Katrien De Braekeleer (Revalidatie centrum Inkendaal) – Valérie De Meue (Service des soins de santé, Direction établissements de soins - section rééducation fonctionnelle / Dienst voor geneeskundige verzorging, Directie Verzorgingsinstellingen en diensten – sectie functionele revalidatie) – Erik de Soir (La Défense/IRSD) – Saskia Decuman (Centre d’expertise en matière d’incapacité de travail de l’INAMI / RIZIV Kenniscentrum arbeidsongeschiktheid) – Céline Franken (Service des soins de santé, Direction établissements de soins - section rééducation fonctionnelle / Dienst voor geneeskundige verzorging, Directie Verzorgingsinstellingen en diensten – sectie functionele revalidatie) – Anne-Sofie Goemanne (UZ Intens) – Nathalie Hargot (Centre d’expertise en matière d’incapacité de travail de l’INAMI / RIZIV Kenniscentrum arbeidsongeschiktheid) –– Aurélie Koziel (CHU Brugman – revalidation neurologique) –Sarah Locht (Maison Médicale du Vieux Molenbeek) – Sarah Lorand (CHU Saint Pierre – UMC Sint Pieter) – Benoit Maertens (CHU-CNRF centre de revalidation de Fraiture) – Yves Paulus (INAMI-RIZIV) – Danielle Prevedello (Erasme) – Thibaut Rappe (Zone de secours Brabant wallon) – Anne-Françoise Rousseau (CHU de Liège) – Eric Salmon (Clinique de la Mémoire, CHU de Liège) – Valérie Servais (Cliniques Universitaires Saint-Luc) – Chris Truyers (Revaliatie centrum Inkendaal) – Frédéric Vallot (Centre Hospitalier de Wallonie Picarde CHwapi, Tournai) – Pierre Van der Rest (Clinique Saint Luc à Bouge) – Kirsten Van Kelst (Centre d’expertise en matière d’incapacité de travail de l’INAMI / RIZIV Kenniscentrum arbeidsongeschiktheid) – Els Van Rossem (Revalidatie centrum Inkendaal) – Daniel Vandenbossche (Service Aide Urgente, Cellule Opérations, Direction Générale Soins de Santé, SPF Santé publique / Dienst Dringende Hulpverlening, Cel Terreinwerking, Directoraat-Generaal Gezondheidszorg, FOD Volksgezondheid) – Patrick Verliefde (INAMI-RIZIV) – Geert Verscuren (Service des soins de santé, Direction établissements de soins - section rééducation fonctionnelle / Dienst voor geneeskundige verzorging, Directie Verzorgingsinstellingen en diensten – sectie functionele revalidatie) – We thank the following experts from the Charité Universitätsmedizin, Berlin, Germany for their help and contribution to the Chapter 3: Claudia Spies – Henning Krampe – Friedrich Borchers – Claudia Denke – Jörn Kiselev – Eva Kornemann - Mandy Mertens – Rebecca Tschorsch – Björn Weiss. TABLE OF CONTENTS LIST OF FIGURES ........................................................................................................ 5 LIST OF TABLES .......................................................................................................... 6 LIST OF ABBREVIATIONS ........................................................................................... 7 1 CHAPTER 1: WHAT IS THE POST-INTENSIVE CARE SYNDROME? .......... 13 1.1 ICU-ACQUIRED WEAKNESS ........................................................................................13 1.2 MENTAL HEALTH PROBLEMS .....................................................................................14 1.2.1 Anxiety and depression ....................................................................................14 1.2.2 PTSD ................................................................................................................14 1.3 COGNITIVE IMPAIRMENT .............................................................................................15 1.4 CONSEQUENCES ON FAMILY MEMBERS ..................................................................16 1.5 QUALITY OF LIFE AND RETURN TO WORK ...............................................................17 2 CHAPTER 2: RISK FACTORS AND PREDICTORS OF PICS-RELATED DISORDERS ................................................................................................... 19 2.1 RISK FACTORS FOR PICS-RELATED DISORDERS ...................................................20 2.1.1 Pre-ICU risk factors ..........................................................................................21 2.1.2 Factors during ICU stay ....................................................................................21 2.1.3 Post-ICU factors ...............................................................................................21 2.1.4 Discussion ........................................................................................................23 2.2 PREDICTORS FOR PICS-RELATED DISORDERS ......................................................23 2.2.1 Predictors for physical outcomes ......................................................................23 2.2.2 Predictors for psychological outcomes .............................................................24 2.2.3 Predictors for cognitive impairment ..................................................................25 2.2.4 Predictors for global outcomes .........................................................................26 2.2.5 Discussion ........................................................................................................26 3 CHAPTER 3: DETECTION OF PICS-RELATED DISORDERS IN PRIMARY CARE SETTING .............................................................................................. 27 3.1 INTRODUCTION .............................................................................................................27 3.2 METHODS ......................................................................................................................27 3.2.1 Literature search strategy .................................................................................27 3.2.2 Search results ...................................................................................................28 3.2.3 Selection criteria for screening tools at GP level ..............................................28 3.3 DETECTION OF PICS IN PRIMARY CARE SETTING ..................................................29 3.3.1 Selection of detection tools for GP level ...........................................................29 3.3.2 Physical function ...............................................................................................30 3.3.3 Mental health domain .......................................................................................32 3.3.4 Cognitive disorders ...........................................................................................34 3.4 APPLICABILITY IN BELGIAN CLINICAL PRACTICE ....................................................36 4 4 CHAPTER 4: EFFECTIVENESS OF INTERVENTIONS: REVIEW OF EVIDENCE ...................................................................................................... 38 4.1 INTRODUCTION .............................................................................................................38 4.2 METHOD .........................................................................................................................38 4.2.1 Literature search ...............................................................................................38 4.2.2 Selection criteria ...............................................................................................38 4.2.3 Data collection and analysis .............................................................................38 4.3 RESULTS ........................................................................................................................40 4.3.1 Search results ...................................................................................................40 4.3.2 Description of included studies .........................................................................40 4.3.3 Exercises and physical rehabilitation ................................................................41 4.3.4 Follow-up consultations ....................................................................................49 4.3.5 Mental health interventions ...............................................................................55 4.3.6
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