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新冠肺炎患者出院后 1 个月随访时的生活质量:孟加拉国最大的三级保健医院的一项横断面研究。

Post-discharge quality of life of COVID-19 patients at 1-month follow-up: A cross-sectional study in the largest tertiary care hospital of Bangladesh.

机构信息

Department of Medicine, Dhaka Medical College, Dhaka, Bangladesh.

Department of Neurology, Dhaka Medical College, Dhaka, Bangladesh.

出版信息

PLoS One. 2023 Jan 31;18(1):e0280882. doi: 10.1371/journal.pone.0280882. eCollection 2023.

Abstract

There is increasing evidence of the post-COVID-19 suffering and decreased quality of life in the COVID-19 patients. This study aimed to assess the quality of life and associated factors of COVID-19 patients at one month after discharge from the hospital. This was a cross-sectional study that was conducted at the post-covid clinic of Dhaka Medical College Hospital (DMCH) where RT-PCR-confirmed adult COVID-19 recovered patients were enrolled one month after discharge from the same hospital. They were consecutively selected from January 01 to May 30. A pretested semi-structured questionnaire was used for the data collection for clinical variables. The generic multi-attributable utility instrument EQ-5D-5L was used for assessing health-related quality of life (HRQoL). A total of 563 patients were enrolled in the study. The patients had a mean age with standard deviation (±SD) of 51.18 (±13.49) years and 55.95% were male. The mean (SD) EQ-5D-5L index score and EQ-VAS scores were 0.78 (±0.19) and 70.26 (±11.13), respectively. Overall, 45.77%, 50.99%, 52.79%, 55.14% and 62.16% had problems (slight to extreme) in the mobility, self-care, usual activities, pain/discomfort and anxiety/depression dimensions, respectively. Patients aged ≥60 years had significant problem in mobility (odds ratio [OR] 3.24, 95% confidence interval [CI]: 1.07-9.77). Female participants were 5.50 times (95% CI: 2.22-13.62) more likely to have problems in their usual activities. In comparison to urban area, living in a peri-urban setting was significantly associated with problems in mobility (OR 1.89, 95% CI: 1.13-3.20), pain/discomfort (OR 1.82, 95% CI: 1.04-3.12) and anxiety/depression (OR 2.16, 95% CI: 1.22-3.84). Comorbid patients were 1.75 times (95% CI: 1.07-2.85) more likely to report problems in the pain/discomfort dimension. Presence of symptom(s) was associated with problems in self-care (OR 3.27, 95%CI: 1.31-8.18), usual-activity (OR 3.08, 95%CI: 1.21-7.87), pain/discomfort dimensions (OR 2.75, 95%CI: 1.09-6.96) and anxiety/depression (OR 3.35, 95%CI: 1.35-8.30). Specific management strategies should be planned to address the factors associated with low health-related quality of life in post-acute care of COVID-19 patients.

摘要

越来越多的证据表明,COVID-19 患者在 COVID-19 后会遭受痛苦,生活质量下降。本研究旨在评估 COVID-19 患者出院后一个月的生活质量及其相关因素。这是一项横断面研究,在达卡医学院医院(DMCH)的新冠后诊所进行,在该诊所招募了从同一医院出院后一个月的经 RT-PCR 确诊的成年 COVID-19 康复患者。他们是从 2023 年 1 月 1 日至 5 月 30 日连续入选的。使用经过预测试的半结构式问卷收集临床变量数据。使用通用多归因效用仪器 EQ-5D-5L 评估健康相关生活质量(HRQoL)。共有 563 名患者入组本研究。患者的平均年龄为 51.18±13.49 岁,55.95%为男性。平均(SD)EQ-5D-5L 指数评分和 EQ-VAS 评分分别为 0.78(±0.19)和 70.26(±11.13)。总体而言,45.77%、50.99%、52.79%、55.14%和 62.16%在移动性、自我护理、日常活动、疼痛/不适和焦虑/抑郁维度上存在轻微到严重的问题。60 岁及以上的患者在移动性方面存在显著问题(比值比 [OR] 3.24,95%置信区间 [CI]:1.07-9.77)。女性参与者在日常活动方面出现问题的可能性是男性的 5.50 倍(95% CI:2.22-13.62)。与城市地区相比,居住在城乡结合部与移动性(OR 1.89,95% CI:1.13-3.20)、疼痛/不适(OR 1.82,95% CI:1.04-3.12)和焦虑/抑郁(OR 2.16,95% CI:1.22-3.84)方面出现问题显著相关。合并症患者在疼痛/不适维度上出现问题的可能性是无合并症患者的 1.75 倍(95% CI:1.07-2.85)。存在症状与自我护理(OR 3.27,95%CI:1.31-8.18)、日常活动(OR 3.08,95%CI:1.21-7.87)、疼痛/不适维度(OR 2.75,95%CI:1.09-6.96)和焦虑/抑郁(OR 3.35,95%CI:1.35-8.30)出现问题相关。应制定特定的管理策略,以解决 COVID-19 患者急性后期与生活质量相关的因素。

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