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描述伴有和不伴有院内康复的非危重症 COVID-19 幸存者的特征。

Characterizing non-critically ill COVID-19 survivors with and without in-hospital rehabilitation.

机构信息

Department of Radiology, Montefiore Medical Center and Albert Einstein College of Medicine, 111 E 210th St, Bronx, NY, 10467, USA.

Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, NY, USA.

出版信息

Sci Rep. 2021 Oct 26;11(1):21039. doi: 10.1038/s41598-021-00246-1.

Abstract

This study investigated pre-COVID-19 admission dependency, discharge assistive equipment, discharge medical follow-up recommendation, and functional status at hospital discharge of non-critically ill COVID-19 survivors, stratified by those with (N = 155) and without (N = 162) in-hospital rehabilitation. "Mental Status", intensive-care-unit (ICU) Mobility, and modified Barthel Index scores were assessed at hospital discharge. Relative to the non-rehabilitation patients, rehabilitation patients were older, had more comorbidities, worse pre-admission dependency, were discharged with more assistive equipment and supplemental oxygen, spent more days in the hospital, and had more hospital-acquired acute kidney injury, acute respiratory failure, and more follow-up referrals (p < 0.05 for all). Cardiology, vascular medicine, urology, and endocrinology were amongst the top referrals. Functional scores of many non-critically ill COVID-19 survivors were abnormal at discharge (p < 0.05) and were associated with pre-admission dependency (p < 0.05). Some functional scores were negatively correlated with age, hypertension, coronary artery disease, chronic kidney disease, psychiatric disease, anemia, and neurological disorders (p < 0.05). In-hospital rehabilitation providing restorative therapies and assisting discharge planning were challenging in COVID-19 circumstances. Knowledge of the functional status, discharge assistive equipment, and follow-up medical recommendations at discharge could enable appropriate and timely post-discharge care. Follow-up studies of COVID-19 survivors are warranted as many will likely have significant post-acute COVID-19 sequela.

摘要

这项研究调查了非危重新冠肺炎幸存者在 COVID-19 前的入院依赖、出院辅助设备、出院后医疗随访建议以及出院时的功能状态,按是否接受院内康复进行分层(分别为 N=155 和 N=162)。在出院时评估了“精神状态”、重症监护病房(ICU)活动能力和改良巴氏指数评分。与非康复患者相比,康复患者年龄更大、合并症更多、入院前依赖性更差、出院时需要更多辅助设备和补充氧气、在医院停留时间更长、医院获得性急性肾损伤、急性呼吸衰竭更多,以及更多的后续转介(p<0.05 均)。心脏病学、血管医学、泌尿科和内分泌学是最常见的转介科室。许多非危重新冠肺炎幸存者的功能评分在出院时异常(p<0.05),并与入院前的依赖性相关(p<0.05)。一些功能评分与年龄、高血压、冠状动脉疾病、慢性肾脏病、精神疾病、贫血和神经系统疾病呈负相关(p<0.05)。在 COVID-19 情况下,提供康复治疗和协助出院计划的院内康复具有挑战性。了解出院时的功能状态、出院辅助设备和随访医疗建议,可以为适当和及时的出院后护理提供依据。需要对 COVID-19 幸存者进行后续研究,因为许多人可能会有明显的急性 COVID-19 后后遗症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0384/8548441/a758b5a2f6df/41598_2021_246_Fig1_HTML.jpg

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