Garg Alpana, Subramain Maran, Barlow Patrick B, Garvin Lauren, Hoth Karin F, Dukes Kimberly, Hoffman Richard M, Comellas Alejandro P
Department of Internal Medicine, Division of General Internal Medicine, University of Iowa, Iowa City, IA, USA.
Institute for Clinical and Translational Science, University of Iowa, Iowa City, IA, USA.
J Patient Exp. 2023 Jan 17;10:23743735231151539. doi: 10.1177/23743735231151539. eCollection 2023.
Post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (PASC) is a complex condition with multisystem involvement. We assessed patients' experience with a PASC clinic established at University of Iowa in June 2020. A survey was electronically mailed in June 2021 asking about (1) symptoms and their impact on functional domains using the Patient-Reported Outcomes Measurement Information System (PROMIS) measures (Global Health and Cognitive Function Abilities) (2) satisfaction with clinic services, referrals, barriers to care, and recommended support resources. Survey completion rate was 35% (97/277). Majority were women (67%), Caucasian (93%), and were not hospitalized (76%) during acute COVID-19. As many as 50% reported wait time between 1 and 3 months, 40% traveled >1 h for an appointment and referred to various subspecialities. Participants reported high symptom burden-fatigue (77%), "brain fog" (73%), exercise intolerance (73%), anxiety (63%), sleep difficulties (56%) and depression (44%). On PROMIS measures, some patients scored significantly low (≥1.5 SD below mean) in physical (22.7%), mental (15.9%), and cognitive (17.6%) domains. Approximately 61% to 93% of participants were satisfied with clinical services. Qualitative analysis added insight to their experience with healthcare. Participants suggested potential strategies for optimizing recovery, including continuity of care, a co-located multispecialty clinic, and receiving timely information from emerging research. Participants appreciated that physicians validated their symptoms and provided continuity of care and access to specialists.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染的急性后遗症（PASC）是一种涉及多系统的复杂病症。我们评估了在2020年6月于爱荷华大学设立的PASC诊所中患者的体验。2021年6月通过电子邮件发送了一项调查问卷，询问（1）使用患者报告结局测量信息系统（PROMIS）量表（全球健康和认知功能能力）评估的症状及其对功能领域的影响，（2）对诊所服务、转诊、就医障碍以及推荐的支持资源的满意度。调查完成率为35%（97/277）。大多数为女性（67%）、白种人（93%），并且在急性新冠病毒病期间未住院（76%）。多达50%的人报告等待时间在1至3个月之间，40%的人前往就诊的路程超过1小时，并转诊至各个专科。参与者报告了较高的症状负担——疲劳（77%）、“脑雾”（73%）、运动不耐受（73%）、焦虑（63%）、睡眠困难（56%）和抑郁（44%）。根据PROMIS量表，一些患者在身体（22.7%）、心理（15.9%）和认知（17.6%）领域的得分显著较低（比平均值低≥1.5标准差）。约61%至93%的参与者对临床服务感到满意。定性分析为他们的就医体验提供了深入见解。参与者提出了优化康复的潜在策略，包括持续护理、设在同一地点的多专科诊所，以及从新出现的研究中及时获取信息。参与者赞赏医生对他们的症状进行了确认，并提供了持续护理以及专科医生的诊疗服务。
