CLARITY (Collaborative Ageing Research) Group, NHS, Bristol, UK.
CLARITY (Collaborative Ageing Research) Group, NHS, Bristol, UK.
J Affect Disord. 2022 Aug 1;310:377-383. doi: 10.1016/j.jad.2022.05.035. Epub 2022 May 11.
Frailty is associated with long-term physical deterioration after COVID-19. Mental health recovery has been less well investigated. Early studies have shown minimal effect from the virus, although studies have not focused on whether people living with frailty may have different psychiatric outcomes. We aimed to examine the effect of living with frailty on mental health outcomes one year after hospital with COVID-19.
We undertook a multicentre cross-sectional study of people admitted with COVID-19. We assessed quality of life (ICECAP-O and MRC), psychiatric symptoms including: generalised anxiety (GAD-7), depression (Patient Health Questionnaire-9), and trauma (Trauma Screening Questionnaire). Frailty was measured using the Clinical Frailty Scale (CFS). We used a multivariable mixed-effects logistic and linear regression to examine the adjusted odds ratio (aOR) and adjusted mean difference (aMD).
From eight hospitals 224 participants consented. Median follow-up time from admission 358 days (IQR 153-418), mean age 63.8 (SD = 13.7), 34.8% female (n = 78), and 43.7% living with frailty (n = 98 CFS 4-8). People living with frailty were significantly more likely to have symptoms of anxiety aOR = 5.72 (95% CI 1.71-19.13), depression aOR = 2.52 (95% CI 1.59-14.91), post-traumatic stress disorder aMD = 1.16 (95% CI 0.47, 1.85), and worse quality of life aMD = 1.06 (95% CI 0.76-1.36).
Patient-rated symptoms were captured rather than formal mental health diagnoses. CFS has not been validated in under 65-year-olds.
Living with frailty is associated with significant psychiatric morbidity and reduced wellbeing one year after COVID-19 hospital admission. We recommend clinical follow-up after COVID-19 for people living with frailty should include a psychiatric assessment.
虚弱与 COVID-19 后长期的身体恶化有关。心理健康的恢复情况则研究较少。早期研究表明病毒的影响很小，尽管这些研究并未关注是否患有虚弱的人可能会有不同的精神科结果。我们旨在研究患有 COVID-19 后在医院住院一年后，虚弱对心理健康结果的影响。
我们对因 COVID-19 住院的患者进行了一项多中心横断面研究。我们评估了生活质量（ICECAP-O 和 MRC），以及包括广泛性焦虑症（GAD-7）、抑郁症（患者健康问卷-9）和创伤（创伤筛查问卷）在内的精神症状。使用临床虚弱量表（CFS）来衡量虚弱程度。我们使用多变量混合效应逻辑和线性回归来检查调整后的优势比（aOR）和调整后的平均差异（aMD）。
从八家医院中，有 224 名患者同意参与。从入院到随访中位数时间为 358 天（IQR 153-418），平均年龄为 63.8（SD=13.7），女性占 34.8%（n=78），43.7%的患者（n=98，CFS 4-8 级）患有虚弱。患有虚弱的患者更有可能出现焦虑症状 aOR=5.72（95%CI 1.71-19.13）、抑郁症状 aOR=2.52（95%CI 1.59-14.91）、创伤后应激障碍 aMD=1.16（95%CI 0.47,1.85）和生活质量下降 aMD=1.06（95%CI 0.76-1.36）。
患者自评的症状而非正式的精神健康诊断。CFS 尚未在 65 岁以下人群中得到验证。
患有虚弱与 COVID-19 住院一年后显著的精神疾病发病率和幸福感下降有关。我们建议对患有 COVID-19 后虚弱的患者进行临床随访时，应包括精神科评估。
