COVID-19 康复者接受联合初级保健的一年评估：一项全国范围的前瞻性队列研究。

One-year evaluation of people recovering from COVID-19 receiving allied primary healthcare: A nationwide prospective cohort study.

机构信息

Department of Epidemiology, Care and Public Health Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P. Debyeplein 1, 6229 HA Maastricht, the Netherlands; Department of Physical Therapy, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, the Netherlands.

Division of Human Nutrition and Health, Wageningen University and Research, Stippeneng 4, 6708 WE Wageningen, the Netherlands.

出版信息

Ann Phys Rehabil Med. 2024 Oct;67(7):101874. doi: 10.1016/j.rehab.2024.101874. Epub 2024 Aug 21.

DOI:10.1016/j.rehab.2024.101874

PMID:39173549

Abstract

BACKGROUND

A Dutch nationwide prospective cohort study was initiated to investigate recovery trajectories of people recovering from coronavirus disease 2019 (COVID-19) and costs of treatment by primary care allied health professionals.

OBJECTIVES

The study described recovery trajectories over a period of 12 months and associated baseline characteristics of participants recovering from COVID-19 who visited a primary care allied health professional. It also aimed to provide insight into the associated healthcare and societal costs.

METHODS

Participants completed participant-reported standardized outcomes on participation, health-related quality of life, fatigue, physical functioning, and costs at baseline (ie, start of the treatment), 3, 6, 9 and 12 months.

RESULTS

A total of 1451 participants (64 % women, 76 % mild/moderate severity) with a mean (SD) age of 49 (12) years were included. Linear mixed models showed significant and clinically relevant improvements over time in all outcome measures between baseline and 12 months. Between 6 and 12 months, we found significant but not clinically relevant improvements in most outcome measures. Having a worse baseline score was the only baseline factor that was consistently associated with greater improvement over time on that outcome. Total allied healthcare costs (mean €1921; SEM €48) made up about 3% of total societal costs (mean €64,584; SEM €3149) for the average participant in the cohort.

CONCLUSIONS

The health status of participants recovering from COVID-19 who visited an allied health professional improved significantly over a 12-month follow-up period, but nearly the improvement occurred between baseline and 6 months. Most participants still reported severe impairments in their daily lives, and generated substantial societal costs. These issues, combined with the fact that baseline characteristics explained little of the variance in recovery over time, underscore the importance of continued attention for the management of people recovering from COVID-19.

TRIAL REGISTRATION

clinicaltrials.gov (NCT04735744).

摘要

背景

一项荷兰全国前瞻性队列研究旨在调查从 COVID-19 中康复的人群的恢复轨迹，以及初级保健相关卫生专业人员的治疗成本。

目的

本研究描述了 12 个月期间的恢复轨迹，以及接受初级保健相关卫生专业人员治疗的 COVID-19 康复参与者的基线特征。它还旨在深入了解相关的医疗保健和社会成本。

方法

参与者在基线（即治疗开始时）、3、6、9 和 12 个月时完成了参与度、健康相关生活质量、疲劳、身体功能和成本的标准化患者报告结果。

结果

共纳入 1451 名参与者（64%为女性，76%为轻度/中度），平均（SD）年龄为 49（12）岁。线性混合模型显示，在所有结局指标中，从基线到 12 个月时均存在显著且具有临床意义的改善。在 6 至 12 个月之间，我们发现大多数结局指标的改善具有显著但不具有临床意义。基线得分越差，与该结局随时间改善相关的唯一基线因素。初级保健相关医疗总费用（平均 1921 欧元；SEM 48 欧元）约占队列中平均参与者总社会成本（平均 64584 欧元；SEM 3149 欧元）的 3%。

结论

接受相关卫生专业人员治疗的 COVID-19 康复者的健康状况在 12 个月的随访期间显著改善，但近 90%的改善发生在基线和 6 个月之间。大多数参与者的日常生活仍存在严重障碍，产生了大量的社会成本。这些问题，加上基线特征仅能解释恢复过程中随时间变化的很小一部分方差，凸显了持续关注 COVID-19 康复者管理的重要性。