{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T22:32:37Z","timestamp":1776378757633,"version":"3.51.2"},"reference-count":40,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T00:00:00Z","timestamp":1768435200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Post-COVID-19 condition (PCC) remains poorly characterized beyond two years, particularly among intensive care unit (ICU) survivors. We aimed to describe the prevalence, persistence, and late consequences of PCC up to 32 months after discharge in an ICU cohort. Methods: This single-center longitudinal cohort included 170 adults with confirmed SARS-CoV-2 infection admitted to an ICU in C\u00e1ceres (Spain) between March 2020 and March 2021. 94 survivors entered follow-up at discharge and 3, 6, 12, 18, 24, and 32 months. PCC manifestations were grouped into five organ system domains (respiratory, cardiovascular, renal, infectious, and musculoskeletal\/neuromuscular) and recorded only when supported by clinician-confirmed diagnoses or diagnostic tests. Prevalence at each visit, persistence, and new onset of manifestations between 3 and 6 months, and the cumulative incidence of new chronic diseases between 18 and 32 months were estimated with 95% confidence intervals. Results: Any PCC manifestation was almost universal at discharge (96.8% [95% CI, 91.1\u201398.9]) and remained high at 12 months (85.2% [95% CI, 76.3\u201391.2]), declining to 48.6% at 24 months and 25.7% at 32 months. Respiratory manifestations predominated early and were largely resolved by 32 months, whereas musculoskeletal\/neuromuscular involvement remained relatively stable. From 18 to 32 months, 36.5% (95% CI, 26.4\u201347.9) of survivors developed at least one chronic condition, most frequently cardiovascular disease (14.9% [95% CI, 8.5\u201324.7]). Conclusions: Long-term PCC manifestations and incident chronic diseases are common among ICU COVID-19 survivors, underscoring the need for prolonged follow-up and post-ICU care.<\/jats:p>","DOI":"10.3390\/jcm15020711","type":"journal-article","created":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T12:31:41Z","timestamp":1768480301000},"page":"711","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prevalence and Persistence of Post-COVID-19 Condition After Critical Care: 32-Month Follow-Up"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5830-9348","authenticated-orcid":false,"given":"Alicia","family":"\u00c1vila Nieto","sequence":"first","affiliation":[{"name":"Doctoral School, University of Valladolid, 47011 Valladolid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1644-9502","authenticated-orcid":false,"given":"Paulo","family":"Infante","sequence":"additional","affiliation":[{"name":"School of Science and Technology, Department of Mathematics, Research Center in Mathematics and Applications, University of \u00c9vora, 7000-671 \u00c9vora, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3532-8255","authenticated-orcid":false,"given":"Francisco Javier","family":"Barca Dur\u00e1n","sequence":"additional","affiliation":[{"name":"Human Anatomy Department, Nursing and Occupational Therapy School, University of Extremadura, 10003 C\u00e1ceres, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,15]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2020). Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19), World Health Organization. Available online: https:\/\/www.who.int\/docs\/default-source\/coronaviruse\/who-china-joint-mission-on-covid-19-final-report.pdf."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1001\/jama.2020.4031","article-title":"Critical care utilization for the COVID-19 outbreak in Lombardy, Italy: Early experience and forecast during an emergency response","volume":"323","author":"Grasselli","year":"2020","journal-title":"JAMA"},{"key":"ref_3","first-page":"e0876","article-title":"Intensive care and organ support related mortality in patients with COVID-19: A systematic review and meta-analysis","volume":"5","author":"Chandel","year":"2023","journal-title":"Crit. Care Explor."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"10","DOI":"10.7196\/SAMJ.2020.v111i11.15433","article-title":"Long-COVID: An evolving problem with an extensive impact","volume":"111","author":"Mendelson","year":"2020","journal-title":"S. Afr. Med. J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e048391","DOI":"10.1136\/bmjopen-2020-048391","article-title":"Multiorgan impairment in low-risk individuals with post-COVID-19 syndrome: A prospective, community-based study","volume":"11","author":"Dennis","year":"2021","journal-title":"BMJ Open"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"n1648","DOI":"10.1136\/bmj.n1648","article-title":"Long covid: Mechanisms, risk factors, and management","volume":"374","author":"Crook","year":"2021","journal-title":"BMJ"},{"key":"ref_7","unstructured":"Rajan, S., Khunti, K., Alwan, N., Steves, C., Greenhalgh, T., MacDermott, N., Sagan, A., and McKee, M. (2021). In the Wake of the Pandemic: Preparing for Long COVID. Health Systems and Policy Analysis, Policy Brief 39, World Health Organization. Available online: https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/339629\/Policy-brief-39-1997-8073-eng.pdf."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"101019","DOI":"10.1016\/j.eclinm.2021.101019","article-title":"Characterizing long COVID in an international cohort: 7 months of symptoms and their impact","volume":"38","author":"Davis","year":"2021","journal-title":"eClinicalMedicine"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Verma, A., Naidu, S.V., Sulthana, H., Ullah, A., Shabil, M., Sah, R., Mehta, R., Jan, A., Ain, N.U., and Rahim, A. (2025). Musculoskeletal manifestations in post-acute sequelae of SARS-CoV-2 infection: A systematic review and meta-analysis. Front. Public Health, 13.","DOI":"10.3389\/fpubh.2025.1662953"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"14799731211002240","DOI":"10.1177\/14799731211002240","article-title":"Prevalence of potential respiratory symptoms in survivors of hospital admission after coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis","volume":"18","author":"Torralba","year":"2021","journal-title":"Chronic Respir. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Huang, L.W., Li, H.M., He, B., Wang, X.B., Zhang, Q.Z., and Peng, W.X. (2025). Prevalence of cardiovascular symptoms in post-acute COVID-19 syndrome: A meta-analysis. BMC Med., 23.","DOI":"10.1186\/s12916-025-03908-3"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"04282","DOI":"10.7189\/jogh.15.04282","article-title":"Prevalence and duration of common symptoms in people with long COVID: A systematic review and meta-analysis","volume":"15","author":"Luo","year":"2025","journal-title":"J. Glob. Health"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1111\/jocn.16537","article-title":"Implications for long COVID: A systematic review and meta-aggregation of experiences of patients diagnosed with COVID-19","volume":"33","author":"Zheng","year":"2024","journal-title":"J. Clin. Nurs."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"E353","DOI":"10.1148\/radiol.2021210033","article-title":"Hyperpolarized 129Xe MRI abnormalities in dyspneic patients 3 months after COVID-19 pneumonia: Preliminary results","volume":"301","author":"Grist","year":"2021","journal-title":"Radiology"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1111\/joim.13558","article-title":"Lung perfusion disturbances in nonhospitalized post-COVID with dyspnea: A magnetic resonance imaging feasibility study","volume":"292","author":"Yu","year":"2022","journal-title":"J. Intern. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"107461","DOI":"10.1016\/j.rmed.2023.107461","article-title":"Longitudinal analysis of chest Q-SPECT\/CT in patients with severe COVID-19","volume":"220","author":"Zivkovic","year":"2023","journal-title":"Respir. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1513\/AnnalsATS.202009-1175OC","article-title":"Persistent poor health after COVID-19 is not associated with respiratory complications or initial disease severity","volume":"18","author":"Townsend","year":"2021","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1016\/S2213-2600(21)00318-0","article-title":"Recovery after prolonged ICU treatment in patients with COVID-19","volume":"9","author":"Parotto","year":"2021","journal-title":"Lancet Respir. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1038\/s41591-021-01283-z","article-title":"Post-acute COVID-19 syndrome","volume":"27","author":"Nalbandian","year":"2021","journal-title":"Nat. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1880","DOI":"10.1111\/ene.15812","article-title":"Neurological and (neuro)psychological sequelae in intensive care and general ward COVID-19 survivors","volume":"30","author":"Klinkhammer","year":"2023","journal-title":"Eur. J. Neurol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e110","DOI":"10.1016\/j.bja.2020.12.007","article-title":"Quality of life, functional status, and persistent symptoms after intensive care of COVID-19 patients","volume":"126","author":"Taboada","year":"2021","journal-title":"Br. J. Anaesth."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1097\/ID9.0000000000000158","article-title":"Long COVID: Current research and future directions","volume":"5","author":"Zhang","year":"2025","journal-title":"Infect. Dis. Immun."},{"key":"ref_23","unstructured":"World Health Organization (2025). Post COVID-19 Condition (Long COVID): Case Definition and Key Considerations, World Health Organization. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/post-covid-19-condition-(long-covid)."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Elias, T.P., Gebreamlak, T.W., Gebremeskel, T.T., Adde, B.L., Abie, A.S., Elias, B.P., Argaw, A.M., Tenaw, A.A., and Belay, B.M. (2024). Determinants of post-acute COVID-19 syndrome among hospitalized severe COVID-19 patients: A 2-year follow-up study. PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0298409"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1111\/jnu.12967","article-title":"Post-acute COVID-19 syndrome in previously hospitalized patients","volume":"56","author":"Eo","year":"2024","journal-title":"J. Nurs. Scholarsh."},{"key":"ref_26","first-page":"308","article-title":"Comparison of baseline characteristics, treatment and outcomes of critically ill patients admitted to ICUs in the first versus second wave of COVID-19: An Australian SPRINT-SARI study","volume":"23","author":"Burrell","year":"2023","journal-title":"Crit. Care Resusc."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e093639","DOI":"10.1136\/bmjopen-2024-093639","article-title":"Two years and counting: A prospective cohort study on the scope and severity of post-COVID symptoms across diverse patient groups in the Netherlands\u2014Insights from the CORFU study","volume":"15","author":"Klein","year":"2025","journal-title":"BMJ Open"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1016\/S2213-2600(22)00126-6","article-title":"Health outcomes in people 2 years after surviving hospitalisation with COVID-19: A longitudinal cohort study","volume":"10","author":"Huang","year":"2022","journal-title":"Lancet Respir. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e70467","DOI":"10.1111\/hex.70467","article-title":"Prevalence and predictors of long COVID in a cohort of Brazilian adults 12 months after acute infection: A cross-sectional study","volume":"28","author":"Covre","year":"2025","journal-title":"Health Expect."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"42","DOI":"10.18087\/cardio.2025.8.n2986","article-title":"Predictors of the devel-opment of newly diagnosed chronic heart failure in patients with shortness of breath in long-term post-COVID syndrome","volume":"65","author":"Masalkina","year":"2025","journal-title":"Kardiologiia"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"DeVoss, R., Carlton, E.J., Jolley, S.E., and Perraillon, M.C. (2025). Healthcare utilization patterns before and after a long COVID diagnosis: A case-control study. BMC Public Health, 25.","DOI":"10.1186\/s12889-025-21393-4"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e70435","DOI":"10.1111\/hex.70435","article-title":"What can we learn four years on? A multi-centre service evaluation exploring symptoms, functional impact, recovery and care pathways in long COVID","volume":"28","author":"Lee","year":"2025","journal-title":"Health Expect."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Joseph, G., Margalit, I., Weiss-Ottolenghi, Y., Rubin, C., Murad, H., Gardner, R.C., Barda, N., Ben-Shachar, E., Indenbaum, V., and Gilboa, M. (2024). Persistence of long COVID symptoms two years after SARS-CoV-2 infection: A prospective longitudinal cohort study. Viruses, 16.","DOI":"10.3390\/v16121955"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Dale, Z., Wallington, S.F., and Penn-Marshall, M. (2025). Prevalence and characteristics of post-acute sequelae of COVID-19 in recovered patients. Front. Public Health, 13.","DOI":"10.3389\/fpubh.2025.1648961"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1111\/jocn.16880","article-title":"Emotional, mental health and physical symptom experience of patients hospitalized with COVID-19 up to 3 months post-hospitalization: A longitudinal study","volume":"33","author":"Tracy","year":"2024","journal-title":"J. Clin. Nurs."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Ahmad, I., Edin, A., Granvik, C., Persson, L.K., Tevell, S., M\u00e5nsson, E., Magnuson, A., Marklund, I., Persson, I.-L., and Kauppi, A. (2023). High prevalence of persistent symptoms and reduced health-related quality of life 6 months after COVID-19. Front. Public Health, 11.","DOI":"10.3389\/fpubh.2023.1104267"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"230","DOI":"10.5694\/mja2.52063","article-title":"Prevalence, pathogenesis and spectrum of neurological symptoms in COVID-19 and post-COVID-19 syndrome: A narrative review","volume":"219","author":"Wesselingh","year":"2023","journal-title":"Med. J. Aust."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1038\/s41591-021-01647-5","article-title":"Post-acute neurological consequences of COVID-19: An unequal burden","volume":"28","author":"Nolen","year":"2022","journal-title":"Nat. Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2265","DOI":"10.1007\/s00415-021-10848-4","article-title":"Acute and post-acute neurological manifestations of COVID-19: Present findings, critical appraisal, and future directions","volume":"269","author":"Beghi","year":"2022","journal-title":"J. Neurol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1080\/14737175.2024.2440543","article-title":"Tackling persistent neurological symptoms in patients following acute COVID-19 infection: An update of the literature","volume":"25","author":"Divani","year":"2025","journal-title":"Expert Rev. Neurother."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/2\/711\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T13:28:51Z","timestamp":1768483731000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/2\/711"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,15]]},"references-count":40,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["jcm15020711"],"URL":"https:\/\/doi.org\/10.3390\/jcm15020711","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,15]]}}}