Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Department of Nosocomial Infection Management, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Front Public Health. 2023 Feb 22;11:1086830. doi: 10.3389/fpubh.2023.1086830. eCollection 2023.
No prior study had reported the psychological and physical recovery of patients with COVID-19 2~3 years after discharge from the hospital. Moreover, it is not clear whether there is any difference in the health status of the patients with COVID-19 of different ages after discharge from the hospital.
Embedding in the "Rehabilitation Care Project for Medical Staff Infected with COVID-19" in China, this study included 271 health care workers (HCWs) with severe COVID-19. Their status of health-related quality of life, persistent symptoms, functional fitness and immune function at 28 months after discharge were followed, and compared according to tertiles of age at SARS-CoV-2 infection (group of younger (≤ 33 years); medium (34-42 years); and older (≥43 years)). Multivariate linear regression and multivariable adjusted logistic regression models were applied in investigating the associations of age at SARS-CoV-2 infection and outcomes.
At 28 months after discharge, 76% of the HCWs with severe COVID-19 had symptom of fatigue/weakness; 18.7% of the HCWs with severe COVID-19 did not fully recover their functional fitness; the decrease of CD3 T cells, CD8 T cells and the increase of natural killer cells accounted for 6.6, 6.6, and 5.5%, respectively. Compared with the HCWs with severe COVID-19 in younger group, HCWs with severe COVID-19 in older group had lower scores regarding physical functioning, role physical, bodily pain and role emotional; HCWs with severe COVID-19 in older group had higher risk of cough, joint pain, hearing loss and sleep disorder; HCWs with severe COVID-19 in older group scored lower on flexibility test. The variance of relative numbers of CD3 T cells, CD8 T cells and natural killer cells among HCWs with severe COVID-19 of different age groups were significant.
This study demonstrated that older HCWs with severe COVID-19 recovered slower than those with younger age regarding health-related quality of life, persistent symptoms, functional fitness and immune function at 28 months after discharge. Effective exercise interventions regarding flexibility should be performed timely to speed their rehabilitation, especially among those with older age.
此前尚无研究报告出院 2~3 年后 COVID-19 患者的心理和身体恢复情况。此外，出院后不同年龄 COVID-19 患者的健康状况是否存在差异也不清楚。
本研究纳入了 271 名重症 COVID-19 医护人员，将其嵌入中国的“COVID-19 医护人员康复关爱项目”中。随访并比较了他们出院 28 个月时的健康相关生活质量、持续症状、功能体能和免疫功能，按照感染 SARS-CoV-2 时的年龄分为 3 个三分位数（年龄较小组（≤33 岁）、年龄中等组（34-42 岁）和年龄较大组（≥43 岁））。采用多元线性回归和多变量调整逻辑回归模型来探讨 SARS-CoV-2 感染年龄与结局的相关性。
出院 28 个月时，76%的重症 COVID-19 医护人员仍有疲劳/乏力症状；18.7%的重症 COVID-19 医护人员的功能体能未完全恢复；CD3 T 细胞、CD8 T 细胞减少和自然杀伤细胞增加的比例分别为 6.6%、6.6%和 5.5%。与年龄较小组的重症 COVID-19 医护人员相比，年龄较大组的重症 COVID-19 医护人员在身体功能、躯体角色、躯体疼痛和情绪角色方面的评分较低；年龄较大组的重症 COVID-19 医护人员咳嗽、关节痛、听力损失和睡眠障碍的风险更高；年龄较大组的重症 COVID-19 医护人员在灵活性测试中的得分较低。不同年龄组重症 COVID-19 医护人员 CD3 T 细胞、CD8 T 细胞和自然杀伤细胞相对数量的差异具有统计学意义。
本研究表明，出院 28 个月时，年龄较大的重症 COVID-19 医护人员在健康相关生活质量、持续症状、功能体能和免疫功能方面的恢复速度较年轻者慢。应及时进行针对灵活性的有效运动干预，以加速他们的康复，尤其是年龄较大者。
