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COVID-19 幸存者的临床结局和生活质量:出院后 3 个月的随访。

Clinical outcomes and quality of life of COVID-19 survivors: A follow-up of 3 months post hospital discharge.

机构信息

Internal Medicine Residency Program, Hospital Israelita Albert Einstein, Brazil.

Department of Big Data, Hospital Israelita Albert Einstein, Brazil.

出版信息

Respir Med. 2021 Aug;184:106453. doi: 10.1016/j.rmed.2021.106453. Epub 2021 May 13.

Abstract

BACKGROUND

Over 66 million people worldwide have been diagnosed with COVID-19. Therefore, understanding their clinical evolution beyond hospital discharge is essential not only from an individual standpoint, but from a populational level.

OBJECTIVES

Our primary aim was to assess the impact of COVID-19 on health-related quality of life (HRQoL) 3 months after hospital discharge. Additionally, we screened for anxiety and depression and assessed important clinical outcomes.

METHODS

This was a single-center cohort study performed in Sao Paulo (Brazil), in which participants were contacted by telephone to answer a short survey. EQ-5D-3L was used to assess HRQoL and clinical data from patients' index admission were retrieved from medical records.

RESULTS

We contacted 251 participants (59.8% males, mean age 53 years old), 69.7% of which had presented with severe COVID-19. At 3 months of follow-up, 6 patients had died, 51 (20.3%) had visited the emergency department again and 17 (6.8%) had been readmitted to hospital. Seventy patients (27.9%) persisted with increased dyspnoea and 81 had a positive screening for anxiety/depression. Similarly, patients reported an overall worsening of EQ-5D-3L single summary index at 3 months compared to before the onset of COVID-19 symptoms (0.8012 (0.7368 - 1.0) vs. 1.0(0.7368 - 1.0), p < 0.001). This affected all 5 domains, but especially pain/discomfort and anxiety/depression. Only female sex and intensive care requirement were independently associated with worsening of HRQoL.

CONCLUSION

Patients hospitalized for COVID-19 frequently face persistent clinical and mental health problems up to 3 months following hospital discharge, with significant impact on patients' HRQoL.

摘要

背景

全球已有超过 6600 万人被诊断出患有 COVID-19。因此,了解他们出院后的临床演变情况不仅从个体角度,而且从人群水平来看都是至关重要的。

目的

我们的主要目的是评估 COVID-19 对出院后 3 个月的健康相关生活质量(HRQoL)的影响。此外,我们还筛查了焦虑和抑郁情况,并评估了重要的临床结局。

方法

这是一项在巴西圣保罗进行的单中心队列研究,通过电话联系参与者以回答简短的调查问卷。使用 EQ-5D-3L 评估 HRQoL,并从患者入院记录中检索临床数据。

结果

我们联系了 251 名参与者(59.8%为男性,平均年龄 53 岁),其中 69.7%患有严重 COVID-19。在 3 个月的随访期间,有 6 名患者死亡,51 名(20.3%)再次就诊于急诊部门,17 名(6.8%)再次住院。70 名患者(27.9%)持续存在呼吸困难加重,81 名患者焦虑/抑郁筛查呈阳性。同样,与 COVID-19 症状出现前相比,患者在 3 个月时报告的 EQ-5D-3L 单项综合指数总体恶化(0.8012(0.7368-1.0)比 1.0(0.7368-1.0),p<0.001)。这影响了所有 5 个领域,但尤其是疼痛/不适和焦虑/抑郁。只有女性性别和重症监护需求与 HRQoL 的恶化独立相关。

结论

因 COVID-19 住院的患者在出院后 3 个月内经常面临持续的临床和心理健康问题,对患者的 HRQoL 产生重大影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15cb/8116128/465f552d0d6d/gr1_lrg.jpg

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