Faculdade de Medicina, Instituto da Criança e do Adolescente, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, SP, Brazil.
Instituto de Medicina Física e Reabilitação, Hospital das Clínicas HCFMUSP, São Paulo, SP, Brazil.
Front Public Health. 2023 Jun 20;11:1117854. doi: 10.3389/fpubh.2023.1117854. eCollection 2023.
To prospectively assess health-related quality of life (HRQoL), global functionality, and disability in primary caregivers of surviving children and adolescents after COVID-19.
A longitudinal observational study was carried out on primary caregivers of surviving pediatric post-COVID-19 patients ( = 51) and subjects without COVID-19 ( = 60). EuroQol five-dimension five-level questionnaire (EQ-5D-5L) and 12-question WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) were answered for both groups. The univariate regression analysis was carried out using SPSS (v 20) and significance was established at 5%.
The median duration between COVID-19 diagnosis in children and adolescents and longitudinal follow-up visits was 4.4 months (0.8-10.7). The median age of children and adolescents caregivers with laboratory-confirmed COVID-19 was similar to primary caregivers of subjects without laboratory-confirmed COVID-19 [43.2 (31.6-60.9) vs. 41.5 (21.6-54.8) years, = 0.08], as well as similar female sex ( = 1.00), level of schooling ( = 0.11), social assistance program ( = 0.28), family income/month U$ ( = 0.25) and the number of household's members in the residence ( = 0.68). The frequency of slight to extreme problems (level ≥ 2) of the pain/discomfort domain according to EQ-5D-5L score was significantly higher in the former group [74% vs. 52.5%, = 0.03, OR = 2.57 (1.14-5.96)]. The frequency of disability according to WHODAS 2.0 total score was similar to those without disability and unknown ( = 0.79); however, with a very high disability in both groups (72.5% and 78.3%). Further analysis of primary caregivers of children and adolescents with post-COVID-19 condition (PCC) [ = 12/51 (23%)] compared to those without PCC [ = 39/51(77%)] revealed no differences between demographic data, EQ-5D-5L and WHODAS 2.0 scores in both groups ( > 0.05).
We longitudinally demonstrated that pain/discomfort were predominantly reported in approximately 75% of primary caregiver of COVID-19 patients, with high disability in approximately three-quarters of both caregiver groups. These data emphasized the prospective and systematic caregiver burden evaluation relevance of pediatric COVID-19.
前瞻性评估 COVID-19 后幸存儿童和青少年的主要照顾者的健康相关生活质量(HRQoL)、整体功能和残疾。
对 COVID-19 后幸存儿科患者( = 51)和无 COVID-19 的主要照顾者( = 60)进行了纵向观察性研究。两组均回答了欧洲五维健康量表(EQ-5D-5L)和 12 项世界卫生组织残疾评估量表 2.0(WHODAS 2.0)。使用 SPSS(v 20)进行单变量回归分析,显著性水平设为 5%。
COVID-19 确诊后儿童和青少年与纵向随访之间的中位时间为 4.4 个月(0.8-10.7)。实验室确诊 COVID-19 的儿童和青少年照顾者的中位年龄与无实验室确诊 COVID-19 的主要照顾者相似[43.2(31.6-60.9)岁 vs. 41.5(21.6-54.8)岁, = 0.08],女性比例[ = 1.00]、教育程度[ = 0.11]、社会援助计划[ = 0.28]、家庭月收入/美元[ = 0.25]和居住家庭人数[ = 0.68]也相似。根据 EQ-5D-5L 评分,疼痛/不适域的轻度至极度问题(水平 ≥ 2)的频率在前一组中明显更高[74% vs. 52.5%, = 0.03,OR = 2.57(1.14-5.96)]。根据 WHODAS 2.0 总分,残疾的频率与无残疾和未知相似( = 0.79);然而,两组的残疾率均非常高(72.5%和 78.3%)。进一步分析 COVID-19 后儿童和青少年的主要照顾者(PCC)[ = 12/51(23%)]与无 PCC 相比[ = 39/51(77%)],两组之间的人口统计学数据、EQ-5D-5L 和 WHODAS 2.0 评分无差异( > 0.05)。
我们进行了纵向研究,结果表明,大约 75%的 COVID-19 患者的主要照顾者主要报告疼痛/不适,大约四分之三的照顾者都存在高度残疾。这些数据强调了儿科 COVID-19 前瞻性和系统性照顾者负担评估的重要性。