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新冠肺炎患者重症监护后长期影响的前瞻性研究。

Long-term effects of Coronavirus 2 infection after intensive care: a prospective study.

机构信息

Azienda Socio Sanitaria Territoriale of Lecco, Lecco, Italy -

Madonna della Neve Onlus, Premana, Lecco, Italy.

出版信息

Minerva Anestesiol. 2023 Mar;89(3):175-187. doi: 10.23736/S0375-9393.22.16728-3. Epub 2022 Jul 14.

Abstract

BACKGROUND

While the multi-organ manifestations of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection are now well-documented, the potential long-term implications of these manifestations remain to be uncovered. The aim of the study was to study the level and predictors of post-traumatic stress, anxiety and depression symptoms, quality of life and functional disability in COVID-19 survivors during the first year post Intensive Care Unit (ICU) discharge.

METHODS

A prospective longitudinal study, reported following the STROBE guidance, was conducted in adult patients with SARS-CoV-2 infection admitted to an Italian ICU from March 2020 to March 2021 who were followed until March 2022.

RESULTS

A total of 207 patients were included in the study, of which 145 (70.1%) were male. One hundred and six (51.2%) patients between six and 12 months after ICU discharge reported at least one physical or cognitive impairment. The concurrent prevalence of anxiety, depression and PTSD is present in 25/106 patients (23.6% of cases) at six months and increases in 29/106 patients (27.3% of cases) at 12 months. However, the prevalence of anxiety, depression and PTSD was observed in 86 patients (41.5%) at six months and it gets smaller in 78 patients (37.7%) at 12 months (P=0.049). The EqVAS score (58.8 vs. 72.3, P=0.017) and the Barthel Index (61.5 vs. 74.8, P<0.001) increased significantly between six and 12 months after ICU.

CONCLUSIONS

Our results show that functional and cognitive recovery improves between six and 12 months after ICU discharge with a high perception of the patients' quality of life. These results will help to inform health system planning and the development of multidisciplinary strategies to reduce chronic health loss among individuals with COVID-19.

摘要

背景

虽然严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 感染的多器官表现现在已经得到很好的记录,但这些表现的潜在长期影响仍有待发现。本研究的目的是研究 COVID-19 幸存者在重症监护病房 (ICU) 出院后第一年创伤后应激、焦虑和抑郁症状、生活质量和功能障碍的水平和预测因素。

方法

这是一项前瞻性纵向研究,遵循 STROBE 指南进行,纳入了 2020 年 3 月至 2021 年 3 月期间因 SARS-CoV-2 感染入住意大利 ICU 的成年患者,随访至 2022 年 3 月。

结果

共有 207 名患者纳入研究,其中 145 名(70.1%)为男性。106 名(51.2%)患者在 ICU 出院后 6-12 个月报告至少有一处身体或认知障碍。6 个月时,25/106 例(23.6%的病例)同时存在焦虑、抑郁和创伤后应激障碍,12 个月时增加到 29/106 例(27.3%的病例)。然而,6 个月时有 86 名患者(41.5%)出现焦虑、抑郁和创伤后应激障碍,12 个月时有 78 名患者(37.7%)减少(P=0.049)。EqVAS 评分(58.8 比 72.3,P=0.017)和巴氏指数(61.5 比 74.8,P<0.001)在 ICU 后 6-12 个月显著增加。

结论

我们的结果表明,功能和认知恢复在 ICU 出院后 6-12 个月之间有所改善,患者生活质量的感知度较高。这些结果将有助于为卫生系统规划和制定多学科策略提供信息,以减少 COVID-19 患者的慢性健康损失。

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