Long-Term Evolution of Activities of Daily Life (ADLs) in Critically Ill COVID-19 Patients, a Case Series.

Background: The most common long-term symptoms of critically ill COVID-19 patients are fatigue, dyspnea and mental confusion. Adequate monitoring of long-term morbidity, mainly analyzing the activities of daily life (ADLs), allows better patient management after hospital discharge. The aim was to report long-term ADL evolution in critically ill COVID-19 patients admitted to a COVID-19 center in Lugano (Switzerland).

Methods: A retrospective analysis on consecutive patients discharged alive from ICU with COVID-19 ARDS was performed based on a follow-up one year after hospital discharge; ADLs were assessed through the Barthel index (BI) and the Karnofsky Performance Status (KPS) scale. The primary objective was to assess differences in ADLs at hospital discharge () and one-year follow-up (chronic ADLs). The secondary objective was to explore any correlations between ADLs and multiple measures at admission and during the ICU stay.

Results: A total of 38 consecutive patients were admitted to the ICU; a -test analysis between acute and through BI showed a significant improvement at one year post discharge (t = -5.211, < 0.0001); similarly, every single task of BI showed the same results ( < 0.0001 for each task of BI). The mean KPS was 86.47 (SD 20.9) at hospital discharge and 99.6 at 1 year post discharge ( = 0.02). Thirteen (34%) patients deceased during the first 28 days in the ICU; no patient died after hospital discharge.

Conclusions: Based on BI and KPS, patients reached complete functional recovery of ADLs one year after critical COVID-19.