Intensive Care Unit–Specific Virtual Reality for Critically Ill Patients with COVID-19: Multicenter Randomized Controlled Trial

Johan H. Vlake, Jasper van Bommel, Evert Jan Wils, Joe Bienvenu, Merel E. Hellemons, Tim I.M. Korevaar, Anna F.C. Schut, Joost A.M. Labout, Lois L.H. Schreuder, Marten P. van Bavel, Diederik Gommers, Michel E. van Genderen

Research output: Contribution to journalArticlepeer-review


Background: Although psychological sequelae after intensive care unit (ICU) treatment are considered quite intrusive, robustly effective interventions to treat or prevent these long-term sequelae are lacking. Recently, it was demonstrated that ICU-specific virtual reality (ICU-VR) is a feasible and acceptable intervention with potential mental health benefits. However, its effect on mental health and ICU aftercare in COVID-19 ICU survivors is unknown. Objective: This study aimed to explore the effects of ICU-VR on mental health and on patients’ perceived quality of, satisfaction with, and rating of ICU aftercare among COVID-19 ICU survivors. Methods: This was a multicenter randomized controlled trial. Patients were randomized to either the ICU-VR (intervention) or the control group. All patients were invited to an COVID-19 post-ICU follow-up clinic 3 months after hospital discharge, during which patients in the intervention group received ICU-VR. One month and 3 months later (4 and 6 months after hospital discharge), mental health, quality of life, perceived quality, satisfaction with, and rating of ICU aftercare were scored using questionnaires. Results: Eighty-nine patients (median age 58 years; 63 males, 70%) were included. The prevalence and severity of psychological distress were limited throughout follow-up, and no differences in psychological distress or quality of life were observed between the groups. ICU-VR improved satisfaction with (mean score 8.7, SD 1.6 vs 7.6, SD 1.6 [ICU-VR vs control]; t64=–2.82, P=.006) and overall rating of ICU aftercare (mean overall rating of aftercare 8.9, SD 0.9 vs 7.8, SD 1.7 [ICU-VR vs control]; t64=–3.25; P=.002) compared to controls. ICU-VR added to the quality of ICU aftercare according to 81% of the patients, and all patients would recommend ICU-VR to other ICU survivors. Conclusions: ICU-VR is a feasible and acceptable innovative method to improve satisfaction with and rating of ICU aftercare and adds to its perceived quality. We observed a low prevalence of psychological distress after ICU treatment for COVID-19, and ICU-VR did not improve psychological recovery or quality of life. Future research is needed to confirm our results in other critical illness survivors to potentially facilitate ICU-VR’s widespread availability and application during follow-up.

Original languageEnglish (US)
Article numbere32368
JournalJournal of medical Internet research
Issue number1
StatePublished - Jan 2022


  • COVID-19
  • Intensive care
  • Post-intensive care syndrome
  • Quality of life
  • SARS-CoV-2
  • Satisfaction
  • Virtual reality

ASJC Scopus subject areas

  • Health Informatics


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