Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, SP, Brazil.
Instituto de Medicina Física e Reabilitação, Hospital das Clinicas HCFMUSP, São Paulo, SP, Brazil.
BMJ Open. 2022 Jul 27;12(7):e057246. doi: 10.1136/bmjopen-2021-057246.
The study investigated the long-term functional status of hospitalised COVID-19 survivors to explore and document their functional situation.
This prospective observational study assessed 801 COVID-19 survivors at 3-11 months after hospital discharge. It analyses participants' sociodemographic background, COVID-19 clinical manifestations, and clinical and functional evaluations.
Tertiary-level university hospital in São Paulo, Brazil.
Study participants are COVID-19 survivors admitted to hospital care for at least 24 hours to treat acute SARS-CoV-2 infection.
Epworth Sleepiness Scale, EuroQoL-5 Dimensions-5 Levels, Functional Assessment of Chronic Illness Therapy-Fatigue, Functional Independence Measure, Functional Oral Intake Scale, Handgrip Strength, Insomnia Severity Index, Medical Research Council (MRC) Dyspnea Scale, MRC sum score, Modified Borg Dyspnea Scale, pain Visual Analogue Scale, Post-COVID-19 Functional Status, Timed Up and Go, WHO Disability Assessment Schedule 2.0, 1-Minute Sit to Stand Test.
Many participants required invasive mechanical ventilation (41.57%, 333 of 801). Mean age was 55.35±14.58 years. With a mean of 6.56 (SD: 1.58; 95% CI: 6.45 to 6.67) months after hospital discharge, 70.86% (567 of 800) reported limited daily activities, which were severe in 5.62% (45 of 800). They also reported pain and discomfort (64.50%, 516 of 800), breathlessness (64.66%, 514 of 795), and anxiety and depression (57.27%, 457 of 798). Daytime sleepiness and insomnia evaluations showed subthreshold results. Most (92.85%, 727 of 783) participants reported unrestricted oral intake. Data indicated no generalised fatigue (mean score: 39.18, SD: 9.77; 95% CI: 38.50 to 39.86). Assessments showed poor handgrip strength (52.20%, 379 of 726) and abnormal Timed Up and Go results (mean 13.07 s, SD: 6.49). The invasive mechanical ventilation group seemed to have a better handgrip strength however. We found no clear trends of change in their functional status during months passed since hospital discharge.
Muscle weakness, pain, anxiety, depression, breathlessness, reduced mobility, insomnia and daytime sleepiness were the most prevalent long-term conditions identified among previously hospitalised COVID-19 survivors.
本研究旨在调查住院 COVID-19 幸存者的长期功能状态，以探讨和记录其功能情况。
本前瞻性观察研究评估了 801 名 COVID-19 幸存者出院后 3-11 个月的情况。分析了参与者的社会人口统计学背景、COVID-19 临床表现以及临床和功能评估。
巴西圣保罗的一所三级大学医院。
研究参与者为因急性 SARS-CoV-2 感染至少住院 24 小时接受医院治疗的 COVID-19 幸存者。
Epworth 嗜睡量表、EuroQoL-5 维度-5 水平、慢性疾病治疗疲劳功能评估、功能独立性测量、功能性口腔摄入量表、握力、失眠严重程度指数、医学研究委员会（MRC）呼吸困难量表、MRC 总分、改良 Borg 呼吸困难量表、疼痛视觉模拟量表、COVID-19 后功能状态、计时起立行走测试、世界卫生组织残疾评估量表 2.0、1 分钟坐立测试。
许多参与者需要接受有创机械通气（41.57%，333/801）。平均年龄为 55.35±14.58 岁。出院后平均 6.56（SD：1.58；95%CI：6.45 至 6.67）个月时，70.86%（800 例中有 567 例）报告日常活动受限，其中 5.62%（800 例中有 45 例）为严重受限。他们还报告了疼痛和不适（64.50%，800 例中有 516 例）、呼吸困难（64.66%，795 例中有 514 例）和焦虑和抑郁（57.27%，798 例中有 457 例）。日间嗜睡和失眠评估显示出亚阈值结果。大多数（92.85%，783 例中有 727 例）参与者报告无限制的口服摄入。数据表明没有普遍疲劳（平均得分：39.18，SD：9.77；95%CI：38.50 至 39.86）。评估显示握力差（52.20%，726 例中有 379 例）和异常计时起立行走结果（平均 13.07 秒，SD：6.49）。接受有创机械通气的组似乎握力更好。我们没有发现自出院以来，他们的功能状态在数月内有明显变化的趋势。
肌肉无力、疼痛、焦虑、抑郁、呼吸困难、活动受限、失眠和日间嗜睡是之前住院的 COVID-19 幸存者中最常见的长期疾病。
