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The number of Americans hospitalized with the virus is increasing again, reaching 41,000 late last week, many with a circle of loved ones holding vigil in their minds, even if they can’t sit at the bedside. A decade ago, critical care clinicians coined the term post-intensive care syndrome, or PICS. It describes the muscle weakness, cognitive changes, anxiety, and other physical and mental symptoms that some ICU patients cope with after leaving the hospital. Those complications are fallout from the medications, immobility, and other possible components of being critically ill. Now they worry that some family members of critically ill COVID patients may develop a related syndrome, PICS-Family.

Studies show that about one-fourth of family members, and sometimes more, experience at least one symptom of PICS-Family, including anxiety, depression, post-traumatic stress disorder or “complicated grief” — grief that is persistent and disabling — when their loved one has been hospitalized, according to a 2012 review article published in the journal Critical Care Medicine. Dr. Daniela Lamas, a critical care physician at Boston’s Brigham and Women’s Hospital, believes relatives and friends of coronavirus patients may be particularly vulnerable.

Hospital rules designed to prevent the spread of the virus have robbed them of the opportunity to sit with their loved ones, watching clinicians provide medical care and gradually processing what’s happening between physician updates, Lamas said. In pre-pandemic times, a nurse “would explain what they had heard [from the doctor] and help them come to terms with unacceptable realities,” she said.

Brief description of media:

The number of Americans hospitalized with the virus is increasing again, reaching 41,000 late last week, many with a circle of loved ones holding vigil in their minds, even if they can’t sit at the bedside. A decade ago, critical care clinicians coined the term post-intensive care syndrome, or PICS. It describes the muscle weakness, cognitive changes, anxiety, and other physical and mental symptoms that some ICU patients cope with after leaving the hospital. Those complications are fallout from the medications, immobility, and other possible components of being critically ill. Now they worry that some family members of critically ill COVID patients may develop a related syndrome, PICS-Family.

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Harris is one of an ever-growing population of COVID-19 survivors who, months later, are still living with the aftermath of their infections. Some have lingering lung damage or must rebuild muscles that became weak after they spent weeks on a ventilator. Others were not even hospitalized, yet still struggle with fatigue, heart palpitations, brain fog or other lingering symptoms.

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When Nina Dalsania Makadia felt the first symptoms of COVID-19 in March, she braced herself for a couple of miserable weeks. The Kennesaw mother of three young children expected the virus to be like a bad cold or the flu. Her headache, chills and fever would require rest and recuperation in bed, she thought. After that, she’d be better, and life would return to normal. But things haven’t returned to normal for the 38-year-old. Three months since falling ill, Makadia still can’t shake extreme exhaustion. Even going up and down the stairs in her home leaves her winded. Then there’s the leg soreness, dizziness and gastrointestinal bleeding.

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The next few months will be full of grim updates about the spread of the new coronavirus, but they will also be full of homecomings. Patients hospitalized with severe COVID-19, some having spent weeks breathing with the help of a mechanical ventilator, will set about resuming their lives. Many will likely deal with lingering effects of the virus—and of the emergency treatments that allowed them to survive it.

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More information continues to emerge about the medical problems COVID-19 infections can cause as our experience with it grows. One feature that has been summarized more lately is the delirium that can develop in the ICU patients, or even as a first symptom. Several factors collectively generate the delirium.

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This guide is for: People who have survived a frightening medical experience, such as being admitted to critical care (intensive care).People who have been hospitalized with severe medical problems related to COVID-19.Their family and friends. Mental health and medical professionals who want to understand more about how to help.

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Conceptual framework of post‐intensive care syndrome (PICS) ICU, intensive care unit, PICS‐F, and PICS – family.

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Over the past several decades, advances in pediatric critical care have saved many lives. As such, contemporary care has broadened its focus to also include minimizing morbidity. Post Intensive Care Syndrome, also known as “PICS,” is a group of cognitive, physical, and mental health impairments that commonly occur in patients after ICU discharge. Post Intensive Care Syndrome has been well-conceptualized in the adult population but not in children.

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Frequently asked questions regard the "Confusion Assessment Method for the ICU" (CAM-ICU)

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This is a training manual for physicians, nurses and other healthcare professionals who wish to use the Confusion Assessment Method for the ICU (CAM-ICU). The CAM-ICU is a delirium monitoring instrument for ICU patients. A complete detailed explanation of how to use the CAM-ICU, as well as answers to frequently asked questions and case studies are provided in this manual.

Brief description of media:

The flow sheet helps the medical practitioner to evaluate the confusion level of the patient in the ICU.