- 10:00: Trial lecture
- 12:00: Public defence
The ordinary opponents are:
- First opponent: Dr. Sabrina Eggmann, Bern University Hospital, Switzerland
- Second opponent: Senior Physician Espen Rostrup Nakstad, Oslo Universitetssykehus, Norway
- Leader of the committee: Professor Elisabeth Krefting Bjelland, Norway
The leader of the public defense is Professor Marit Kirkevold, OsloMet.
The main supervisor is Associate Professor Professor Kristin Hofsø, Lovisenberg Diaconal University College. The co-supervisors are Professor Milada Cvancarova Hagen, OsloMet and Senior Physician Eirik Alnes Buanes, Haukland University Hospital.
Thesis abstract
The COVID-19 pandemic was officially announced in March 2020, resulting in a large cohort of patients needing intensive care unit treatment worldwide. Long-term symptoms and impairments are common in intensive care unit (ICU) survivors and can last months and years after discharge from the hospital.
Aims and methods
This project aimed to investigate long-term outcomes in COVID-19 patients admitted to ICUs in Norway, as this was a new population of ICU patients, and it was essential to gain new knowledge about this group. The long-term outcomes were investigated by conducting a national observational study. The project was a collaboration between Oslo University Hospital and the Norwegian Intensive Care and Pandemic Registry.
Long-term outcomes were assessed using questionnaires administered by the national registry during the first year after admission to the hospital. In addition, the study group used questionnaires and a neurocognitive test using telephone interviews at 6 and 12 months after admission to the ICU. Patients above 18 years of age from the three first admission waves (1 March 2020 – 30 June 2021) who could understand Norwegian were included.
The first paper
In the first paper, we investigated symptoms of post-traumatic stress in the first wave of patients (1 March 2020 – 30 June 2020) six months after admission to the ICU. We found that 22.5 percent of the patients reported having symptoms of post-traumatic stress and that younger age, being a female and having a high respiratory rate at admission to the emergency department were associated with reporting post-traumatic stress symptoms.
The second paper
In the second paper, we investigated objective cognitive impairment at 6 and 12 months in the patients admitted between 1 March 2020 and 30 June 2021. We found that 23.1 percent of the patients had cognitive impairment at six months, measured with the neurocognitive test conducted over the telephone. At 12 months follow-up, this prevalence was decreased to 11.1 percent.
Older age and having symptoms of depression were associated with cognitive impairment. We also investigated subjective cognitive complaints and found this much more prevalent than cognitive impairment measured with the neurocognitive test. At the 12-month follow-up, almost half of the patients reported having more difficulties concentrating, finding the correct word, and having a worse memory than before.
The third paper
In the third and final paper, we investigated fatigue. Fatigue was one of the most prevalent symptoms in our study sample, with 75.4 percent reporting this at three months and 61.5 percent at 12 months' follow-up. We found multiple associations with reporting fatigue. The most essential associations were younger age, and reporting pain/discomfort and dyspnoea.
Conclusion
In conclusion, we found that Norwegian COVID-19 patients admitted to ICU had a high total burden of symptoms during the first year after hospitalisation. Our findings suggest that this patient population should be offered follow-up care with a broad symptom screening.
