At hospital discharge, >1/3 of Acute Respiratory Distress Syndrome (ARDS) survivors had muscle weakness. Greater strength at discharge and throughout follow-up was associated with improved 5-year survival. In patients with post-ICU weakness, both persisting and resolving trajectories, were commonly experienced and associated with worse survival during follow-up. Strength was evaluated with standardized manual muscle testing using the Medical Research Council sumscore (range: 0–60, higher is better), with post-ICU weakness defined as sumscore <48.

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