Circadian health after critical COVID-19 illness: a 24-month follow-up study

Abstract A substantial proportion of critical illness survivors experience circadian disruptions following intensive care unit (ICU) discharge. However, the long-term circadian function in these patients remains poorly understood. This study aimed to characterize the circadian health of ICU survivors over a 24 month follow-up. Patients admitted to the ICU due to SARS-CoV-2 infection were recruited, and rest–activity rhythms (7-day actigraphy), mental health (Hospital Anxiety and Depression Scale), quality of life (12-item Short Form Survey), and respiratory function (spirometry) were assessed at short-term follow-up and at 24 months. The main analysis included 52 patients (65.4% male) with a mean (SD) age of 59.2 (8.27) years. The cohort showed a mean (95% CI) increase in circadian function index (CFI) of 0.06 (0.03–0.09). Participants were categorized into two groups: those without and those with a clinically meaningful improvement, defined as a ≥ 10% increase in CFI. Improvements in CFI correlated with changes in DLCO (rrm = 0.31; 0.04–0.54) and FEV 1 (0.43; 0.17–0.63). Longer duration of invasive mechanical ventilation was associated with lower CFI at 24 months (effect size = –0.338; –0.637 to –0.038). These findings indicate that while some survivors show circadian recovery over 24 months, others exhibit persistent alterations, supporting circadian-focused strategies in post-ICU rehabilitation.

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Publication Details

Journal
Scientific Reports
Published
2026-08-20
DOI
https://doi.org/10.1038/s41598-026-67004-z
Primary Topic
Intensive Care Unit Cognitive Disorders
Type
article
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article

Circadian health after critical COVID-19 illness: a 24-month follow-up study

Jordi de Batlle, Gonzalo Labarca, Olga Mínguez, Sally Santisteve et al.
Scientific Reports
Intensive Care Unit Cognitive Disorders
article

Circadian health after critical COVID-19 illness: a 24-month follow-up study

Jordi de Batlle, Gonzalo Labarca, Olga Mínguez, Sally Santisteve, Rafaela Vaca, Sulamita Carvalho-Brugger, David de Gonzalo‐Calvo, Nuria Forns, Jesús Caballero, María Águilà, Anna Sánchez-Cucó, Anna Galán-González, Carlota Regany, Adriano D. S. Targa, Mario Henríquez-Beltrán, Anna Vila, Iván D. Benítez, Paula Rodriguez Ibañez, Jessica González, Anna Moncusí-Moix, Carlos Rodríguez-Muñoz, Carme Barberà, Gerard Torres, Monica Raluy, Antoni Torres, Nerea Ramirez Seco, Ferran Barbé, Teresa Farre, Paula González
article en

Abstract

Abstract A substantial proportion of critical illness survivors experience circadian disruptions following intensive care unit (ICU) discharge. However, the long-term circadian function in these patients remains poorly understood. This study aimed to characterize the circadian health of ICU survivors over a 24 month follow-up. Patients admitted to the ICU due to SARS-CoV-2 infection were recruited, and rest–activity rhythms (7-day actigraphy), mental health (Hospital Anxiety and Depression Scale), quality of life (12-item Short Form Survey), and respiratory function (spirometry) were assessed at short-term follow-up and at 24 months. The main analysis included 52 patients (65.4% male) with a mean (SD) age of 59.2 (8.27) years. The cohort showed a mean (95% CI) increase in circadian function index (CFI) of 0.06 (0.03–0.09). Participants were categorized into two groups: those without and those with a clinically meaningful improvement, defined as a ≥ 10% increase in CFI. Improvements in CFI correlated with changes in DLCO (rrm = 0.31; 0.04–0.54) and FEV 1 (0.43; 0.17–0.63). Longer duration of invasive mechanical ventilation was associated with lower CFI at 24 months (effect size = –0.338; –0.637 to –0.038). These findings indicate that while some survivors show circadian recovery over 24 months, others exhibit persistent alterations, supporting circadian-focused strategies in post-ICU rehabilitation.

Scientific Reports
Pontificia Universidad Católica de Chile (CL), Instituto de Salud Carlos III (ES), Hospital Universitari Arnau de Vilanova (ES), Hospital Universitari de Santa Maria (ES), Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (ES), Hospital Clínic de Barcelona (ES), Universidad Adventista de Chile (CL), Instituto de Investigación Biomédica de Lleida (ES)
Fundación Eugenio Rodríguez Pascual, Institució Catalana de Recerca i Estudis Avançats, Sociedad Española de Neumología y Cirugía Torácica, Universitat de Lleida, Agència de Gestió d'Ajuts Universitaris i de Recerca, Instituto de Salud Carlos III, European Regional Development Fund
Good health and well-being
Openalex Percentile: Top 9%
Intensive Care Unit Cognitive Disorders
DOIOpen Access PDFOpenAlex
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