Prevalence, characteristics and longer-term outcomes of patients with persistent critical illness due to COVID-19 in Scotland: a national cohort study

Background: Patients with coronavirus disease (COVID-19) can require critical care for prolonged periods. Patients with Persistent Critical Illness can have complex recovery trajectories but this has not been researched for patients with COVID-19. We examined the prevalence, risk factors and long-term outcomes of critically ill COVID-19 patients with persistent critical illness. Methods: A national cohort study of all adults admitted to Scottish critical care units with COVID-19 from 01/03/20 to 04/09/21. Persistent critical illness was defined as a critical care length of stay (LOS) of ≥10 days. Outcomes included one-year mortality and hospital readmission following critical care discharge. Fine and Gray competing risk analysis was used to identify factors associated with Persistent Critical Illness with death as a competing risk. Results: 2236 patients with COVID-19 were admitted to critical care. 1045 patients were identified as developing Persistent Critical Illness, comprising 46.7% of the cohort but using 80.6% of bed-days. Persistent Critical Illness patients used more organ support, had longer post-critical care LOS and longer total hospital LOS. Persistent critical illness was not significantly associated with long-term mortality or hospital readmission. Risk factors associated with increased hazard of Persistent Critical Illness include age, illness severity, organ support on admission and fewer comorbidities. Conclusion: Almost half of all critical care patients with COVID-19 develop persistent critical illness, with high resource use in critical care and beyond. However, persistent critical illness was not associated with a significantly worse long-term outcomes compared to patients who were critically ill for shorter periods

COVID-19 infection and maternal morbidity in critical care units in Scotland: a national cohort study

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