Abstract：
Background: The aim of this study was to investigate the development of fatigue and mental illness between 3 and 12 months after critical COVID-19 and explore risk factors for long-lasting symptoms. Study Design and Methods: A prospective, multicenter COVID-19 study in southern Sweden, including adult patients (≥18 years) with rtPCR-confirmed COVID-19 requiring intensive care. Survivors were invited to a follow-up at 3 and 12 months, where patient-reported symptoms were assessed using the Modified Fatigue Impact Scale (MFIS), the Hospital Anxiety and Depression Scale (HADS) and the Posttraumatic Stress Disorder Checklist version 5 (PCL-5). The development between 3 and 12 months was described by changes in relation to statistical significance and suggested values for a minimally important difference (MID). Potential risk factors for long-lasting symptoms were analyzed by multivariable logistic regression. Results: At the 3-month follow-up, 262 survivors (87%) participated, 215 (72%) returned at 12 months. Fatigue was reported by 50% versus 40%, with a significant improvement at 12 months (MFIS; median 38 vs. 33, P < .001, MID ≥4). There were no significant differences in symptoms of mental illness between 3 and 12 months, with anxiety present in 33% versus 28%, depression in 30% versus 22%, and posttraumatic stress disorder in 17% versus 13%. A worse functional outcome and less sleep compared to before COVID-19 were risk factors for fatigue and mental illness at 12 months. Conclusions: Fatigue improved between 3 and 12 months but was still common. Symptoms of mental illness remained unchanged with anxiety being the most reported. A worse functional outcome and less sleep compared to before COVID-19 were identified as risk factors for reporting long-lasting symptoms.
摘要：
背景：这项研究的目的是调查严重COVID-19后3至12个月疲劳和精神疾病的发展，并探讨长期症状的危险因素。研究设计与方法：前瞻性，瑞典南部的多中心COVID-19研究，包括需要重症监护的rtPCR确诊COVID-19的成年患者(≥18岁)。幸存者被邀请在3个月和12个月进行随访，使用改良的疲劳影响量表（MFIS）评估患者报告的症状，医院焦虑和抑郁量表（HADS）和创伤后应激障碍清单第5版（PCL-5）。3至12个月之间的发展通过与统计显著性相关的变化和最小重要差异（MID）的建议值来描述。通过多变量logistic回归分析长期症状的潜在危险因素。结果：在3个月的随访中，262名幸存者（87％）参加，215（72％）在12个月时返回。疲劳报告为50%对40%，在12个月时有显著改善(MFIS；中位数38vs.33，P<.001，MID≥4）。在3至12个月之间，精神疾病的症状没有显着差异，焦虑分别为33%和28%，抑郁症在30%对22%，创伤后应激障碍的比例分别为17%和13%。与COVID-19之前相比，功能预后更差，睡眠减少是12个月时疲劳和精神疾病的危险因素。结论：疲劳在3到12个月之间有所改善，但仍然很常见。精神疾病的症状保持不变，焦虑是最多的报道。与COVID-19之前相比，更差的功能结果和更少的睡眠被确定为报告长期症状的危险因素。
