The Correlation of Length of Stay in Intensive Care with Duration of Ventilator Support Usage toward Post-COVID-19 Syndrome Incidence and Mortality in COVID-19 Survivors

Abstract

COVID-19 patients have some clinical manifestations, from the mildest form to the critical. Patients who survived COVID-19 have a risk of developing persistent organ systems impairment for more than 12 weeks, namely post-COVID-19 Syndrome (PCS). This study aimed to analyze the intensive care length of stay and duration ventilator support usage as predictors of PCS incidence and mortality in COVID-19 survivors. This observational analytic study included COVID-19 patients who were taken care of in the Intensive care unit (ICU) of Dr. Soetomo General Hospital who were affirmed to be revived from COVID-19 from May to November 2020. PCS symptoms were investigated via telephone to the COVID-19 survivors and responsible family/ relatives. ROC analysis was generated to identify the comparison and the cut-off of ICU length of stay and ventilator usage toward PCS and mortality in COVID-19 survivors. A total of 104 study participants who agreed with the informed consent and were eligible for this study, were followed up. The median length of stay in ICU was 8 days, and the average duration of ventilator usage was 8,9 days. Mortality occurred in 22 participants (21,2%). PCS after intensive care was experienced by 44 patients (53,7%). The most frequent symptoms were: fatigue, cough, and insomnia. There was a significant result of ICU length of stay in PCS patients (p<0,001). The cut-off point of ICU length of stay toward PCS incidence was 8 days (AUC0,824) with a Relative Risk (RR) of 2,5 (1,7-3,7). A significant difference was documented in the length of ICU stay with mortality (p=0,042). The cut-off point of the length of stay with patients? mortality was 8 days (AUC 0,641) with RR 2,4 (1,1 ? 5,2). Neither PCS incidence nor mortality was significantly correlated with ventilator usage. ICU length of stay was a predictor of PCS incidence and mortality in CODID-19 survivors after the intensive care. Duration of ventilator support usage was not correlated with the PCS incidence and mortality in COVID-19 survivors after the ICU discharge.