Intensive Care Medicine Department. Centro Hospitalar Universitário de São João. Porto. Portugal.
Acta Med Port. 2021 Aug 31;34(9):601-607. doi: 10.20344/amp.16277.
Long-term health impairments are often experienced among survivors of critical illness, which may have a negative impact on their quality of life. The aim of this study was to characterize COVID-19 survivors of critical illness and to evaluate health-related quality of life and disability following hospital discharge.
This is a retrospective case-series study that included COVID-19 survivors admitted to the Intensive Care Medicine Department of a University Hospital. Follow-up evaluation was performed between the 30th and the 90th day after discharge. Quality of life was explored using the five-level version of the EQ-5D instrument (EQ-5D-5L) and functionality using the 12-question World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0).
Forty-five survivors were enrolled, 28 (62.2%) men, median age 63.0 years. The EQ-5D-5L questionnaire showed moderate to extreme problems in some dimension in 29 patients (64.4%): mobility in six (13.3%), self-care in seven (13.3%), usual activities in 23 (51.1%), pain/discomfort in 14 (31.1%) and anxiety/depression in 17 (37.8%). When using the 12-question WHODAS 2.0 questionnaire, moderate to extreme disability was reported in some question in 37 patients (82.2%): 19 (42.2%) in standing for long periods, 18 (40.0%) in long-distance walking; 14 (31.1%) on taking care of household responsibilities and 17 (37.8%) in their day-to-day work; 23 (51.1%) felt emotionally affected by their health problems.
Based on COVID-19 survivors-reported outcomes after critical illness, mobility, pain/discomfort, and anxiety/depression were the main problems that persisted one to three months after hospital discharge.
An organized follow-up structure is crucial to improve health-related quality of life in critical COVID-19 survivors.
危重病幸存者常经历长期健康损害,这可能对其生活质量产生负面影响。本研究旨在描述危重症 COVID-19 幸存者,并评估其出院后的健康相关生活质量和残疾情况。
这是一项回顾性病例系列研究,纳入了入住大学医院重症医学科的 COVID-19 幸存者。出院后第 30 至 90 天进行随访评估。使用 EQ-5D-5L 五维量表评估生活质量,使用 WHODAS 2.0 十二项量表评估功能。
共纳入 45 名幸存者,28 名(62.2%)为男性,中位年龄 63.0 岁。EQ-5D-5L 问卷显示 29 名患者(64.4%)在某些维度存在中度至重度问题:6 名(13.3%)活动受限,7 名(13.3%)自我护理,23 名(51.1%)日常活动,14 名(31.1%)疼痛/不适,17 名(37.8%)焦虑/抑郁。使用 WHODAS 2.0 十二项问卷时,37 名患者(82.2%)报告在某些问题上存在中度至重度残疾:19 名(42.2%)长时间站立,18 名(40.0%)长距离行走,14 名(31.1%)料理家务,17 名(37.8%)日常工作;23 名(51.1%)的情绪受到健康问题的影响。
根据危重病 COVID-19 幸存者出院后的报告结果,活动受限、疼痛/不适和焦虑/抑郁是出院后 1 至 3 个月内持续存在的主要问题。
建立有组织的随访结构对于改善危重症 COVID-19 幸存者的健康相关生活质量至关重要。