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住院期间和出院后 COVID-19 患者持续的躯体症状负担和睡眠障碍:一项前瞻性队列研究。

Persistent Somatic Symptom Burden and Sleep Disturbance in Patients with COVID-19 During Hospitalization and After Discharge: A Prospective Cohort Study.

机构信息

Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China (mainland).

Shantou University Medical College, Shantou, Guangdong, China (mainland).

出版信息

Med Sci Monit. 2021 Apr 15;27:e930447. doi: 10.12659/MSM.930447.

Abstract

BACKGROUND The present study was designed to reveal the trajectory of self-reported somatic symptom burden and sleep quality over time in patients with COVID-19 and to identify prognostic factors for greater somatic symptom burden and sleep disturbance. MATERIAL AND METHODS Seventy-four patients with COVID-19 were prospectively followed for longitudinal assessment of somatic symptom burden and sleep quality. We used the 8-item Somatic Symptom Scale (SSS-8) and the modified Medical Research Council (mMRC) scale for somatic symptom burden and the Pittsburgh Sleep Quality Index for sleep quality investigation. Univariate and multivariate analyses were performed to identify independent factors associated with somatic symptom burden and sleep quality. RESULTS Although the degree of physical discomfort and sleep quality issues tended to decline during self-quarantine, patients still experienced these problems to a certain degree. Univariate and multivariate analyses showed that SSS-8 scores at admission (relative risk [RR] 1.234, 95% CI 1.075-1.417, P=0.003) and mMRC scores at discharge (RR 2.420, 95% CI 1.251-4.682, P=0.009) were 2 independent prognostic indicators of somatic symptom burden. In addition, muscle pain as a chief complaint (RR 4.682, 95% CI 1.247-17.580, P<0.022) and history of use of hypnotic drugs (RR 0.148, 95% CI 0.029-0.749, P<0.019) were 2 independent indicators of patient sleep quality during hospitalization. CONCLUSIONS To the best of our knowledge, the present study was the first dynamic assessment of the somatic symptom burden and sleep quality in patients with COVID-19 during hospitalization and quarantine after discharge. Patients with high somatic symptom burden at admission, especially muscle pain as the chief complaint, are prone to having a higher physical burden and more sleep disturbance at discharge.

摘要

背景

本研究旨在揭示 COVID-19 患者自我报告的躯体症状负担和睡眠质量随时间的变化轨迹,并确定躯体症状负担和睡眠障碍更大的预后因素。

材料和方法

74 例 COVID-19 患者前瞻性随访,纵向评估躯体症状负担和睡眠质量。我们使用 8 项躯体症状量表(SSS-8)和改良的医学研究委员会(mMRC)量表评估躯体症状负担,使用匹兹堡睡眠质量指数评估睡眠质量。进行单因素和多因素分析,以确定与躯体症状负担和睡眠质量相关的独立因素。

结果

虽然在自我隔离期间身体不适和睡眠质量问题的程度趋于下降,但患者仍在一定程度上存在这些问题。单因素和多因素分析显示,入院时的 SSS-8 评分(相对风险 [RR] 1.234,95%置信区间 1.075-1.417,P=0.003)和出院时的 mMRC 评分(RR 2.420,95%置信区间 1.251-4.682,P=0.009)是躯体症状负担的 2 个独立预后指标。此外,以肌肉疼痛为主要主诉(RR 4.682,95%置信区间 1.247-17.580,P<0.022)和使用催眠药物史(RR 0.148,95%置信区间 0.029-0.749,P<0.019)是住院期间患者睡眠质量的 2 个独立指标。

结论

据我们所知,本研究首次对 COVID-19 患者住院期间和出院后隔离期间的躯体症状负担和睡眠质量进行了动态评估。入院时躯体症状负担较高的患者,特别是以肌肉疼痛为主要主诉的患者,出院时更容易出现更高的身体负担和更多的睡眠障碍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/240a/8057653/a5d5d430311b/medscimonit-27-e930447-g001.jpg

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