Anesthesiology and Intensive Care Medicine, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Department of Anesthesia and Intensive Care, Uppsala University, Akademiska sjukhuset, Ing 70, 751 85, Uppsala, Sweden.
Sci Rep. 2023 Oct 21;13(1):18035. doi: 10.1038/s41598-023-45346-2.
In survivors of severe coronavirus disease 2019 (COVID-19) incomplete mental and physical recovery may considerably impact daily activities and health-related quality of life (HRQoL). HRQoL can be evaluated with the RAND-36 questionnaire, a multidimensional instrument that assesses physical and mental aspects of health in eight dimensions. The objective was to investigate HRQoL in intensive care patients previously treated for COVID-19 at three Nordic university hospitals, in a prospective multi-center cohort study. HRQoL was measured using RAND-36, 3-9 months after discharge from intensive care units (ICU). One hospital performed a second follow-up 12 months after discharge. A score under the lower limit of the 95% confidence interval in the reference cohorts was considered as significantly reduced HRQoL. We screened 542 and included 252 patients. There was more than twice as many male (174) as female (78) patients and the median age was 61 (interquartile range, IQR 52-69) years. Hypertension was the most common comorbidity observed in 132 (52%) patients and 121 (48%) patients were mechanically ventilated for a median of 8 (IQR 4-14) days. In RAND-36 physical functioning, physical role functioning, general health (p < 0.001 for all) and social functioning (p < 0.05) were below reference, whereas bodily pain, emotional role functioning and mental health were not. In a time-to-event analysis female sex was associated with a decreased chance of reaching the reference HRQoL in the physical function, bodily pain and mental health dimensions. Higher body mass index was found in the physical functioning dimension and hypertension in the physical functioning, vitality and social functioning dimensions. Similar results were seen for diabetes mellitus in general health, vitality and mental health dimensions, as well as pulmonary illness in the physical role functioning dimension and psychiatric diagnosis in the social functioning dimension. Mechanical ventilation was associated with a decreased likelihood of achieving reference HRQoL in the bodily pain and physical functioning dimensions. Patients treated in an ICU because of COVID-19 had lower HRQoL 3-9 months after ICU discharge than 95% of the general population. Physical dimensions were more severely affected than mental dimensions. Female sex and several comorbidities were associated with a slower rate of recovery.Study registration: clinicaltrials.gov: NCT04316884 registered on the 13th of March 2020, NCT04474249 registered on the 29th of June 2020 and NCT04864938 registered on the 4th of April 2021.
在严重的 2019 年冠状病毒病（COVID-19）幸存者中，精神和身体恢复不完全可能会严重影响日常活动和健康相关的生活质量（HRQoL）。HRQoL 可以使用 RAND-36 问卷进行评估，该问卷是一种多维工具，可在八个维度上评估身体和心理健康状况。目的是在三个北欧大学医院的 COVID-19 重症监护患者中，前瞻性地进行多中心队列研究，调查 HRQoL。在从重症监护病房（ICU）出院 3-9 个月后，使用 RAND-36 进行 HRQoL 测量。一家医院在出院后 12 个月进行了第二次随访。参考队列中 95%置信区间下限以下的评分被认为是 HRQoL 显著降低。我们筛查了 542 名患者，并纳入了 252 名患者。男性（174 名）是女性（78 名）的两倍多，中位年龄为 61 岁（四分位距 IQR，52-69）。高血压是最常见的合并症，132 名（52%）患者中有高血压，121 名（48%）患者需要机械通气，中位时间为 8（IQR，4-14）天。在 RAND-36 身体功能、身体角色功能、总体健康（所有维度 p<0.001）和社会功能（p<0.05）方面，身体疼痛、情绪角色功能和心理健康方面的评分均低于参考值。在时间事件分析中，女性性别与身体功能、身体疼痛和心理健康维度达到参考 HRQoL 的机会降低有关。更高的体重指数与身体功能维度有关，高血压与身体功能、活力和社会功能维度有关。在一般健康、活力和心理健康维度中也发现了糖尿病的类似结果，在身体角色功能维度中发现了肺部疾病，在社会功能维度中发现了精神科诊断。机械通气与身体疼痛和身体功能维度达到参考 HRQoL 的可能性降低有关。因 COVID-19 在 ICU 接受治疗的患者在 ICU 出院后 3-9 个月的 HRQoL 低于普通人群的 95%。身体维度的影响比心理维度更严重。女性性别和几种合并症与恢复速度较慢有关。研究注册：clinicaltrials.gov：NCT04316884 于 2020 年 3 月 13 日注册，NCT04474249 于 2020 年 6 月 29 日注册，NCT04864938 于 2021 年 4 月 4 日注册。
