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新冠病毒病对急性后康复后残疾的长期影响:一项试点研究。

The Long-Term Impact of COVID-19 on Disability after Post-Acute Rehabilitation: A Pilot Study.

作者信息

Potcovaru Claudia-Gabriela, Salmen Teodor, Potcovaru Ana Mădălina, Săndulescu Ioana-Miruna, Chiriac Ovidiu, Balasa Ana-Cristinel, Diaconu Laura Sorina, Poenaru Daniela, Pantea Stoian Anca, Cinteza Delia, Berteanu Mihai

机构信息

Doctoral School of Carol Davila, University of Medicine and Pharmacy, 050474 Bucharest, Romania.

National Institute of Rehabilitation, Physical Medicine and Balneoclimatology, 030079 Bucharest, Romania.

出版信息

J Clin Med. 2024 Aug 9;13(16):4694. doi: 10.3390/jcm13164694.

Abstract

The long-term effect of the 2019 coronavirus (COVID-19) pandemic is not fully known. Severe cases of COVID-19 have resulted in disability that can be assessed in a biopsychosocial manner with the International Classification of Functioning, Disability and Health with the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) questionnaire. This study aimed to evaluate the long-term effects on disability of COVID-19 three years after post-acute rehabilitation using WHODAS 2.0. : This single-center cohort study included patients with severe COVID-19 who underwent immediate post-discharge post-acute rehabilitation intervention. Three years later, patients were assessed via telephone using the WHODAS 2.0 questionnaire. Of the 69 patients identified in the hospital database, 27 responded. A total of 16 patients refused to respond due to emotional distress. The mean age was 63.4 ± 8.6 years, 81.5% were independent in the community, 55.3% had been previously admitted to the ICU, and the median rehabilitation hospitalization duration was 18 (11.5,24) days. Comorbidities included type 2 diabetes mellitus (DM) (55.5%), grade 2 high blood pressure (62.9%), pressure ulcers (37%), peripheral neurologic deficits (62.9%), and central neurological deficits (14.8%). ICU admission was significantly correlated with advanced rehabilitation needs (measured by the level of the rehabilitation ( < 0.01) and longer hospitalizations (measured by total days in the hospital ( < 0.001). The overall disability score was 35.09%, significantly influenced by DM and central neurological deficits. Central neurological deficits and DM are associated with higher disability scores. Tailored rehabilitation programs, ongoing medical assessment, integrated care models, and patient education are essential for improving long-term outcomes after COVID-19 disease.

摘要

2019冠状病毒病(COVID-19)大流行的长期影响尚不完全清楚。COVID-19的重症病例导致了残疾,可使用世界卫生组织残疾评定量表2.0(WHODAS 2.0)问卷,按照国际功能、残疾和健康分类,从生物心理社会角度进行评估。本研究旨在使用WHODAS 2.0评估急性康复后三年COVID-19对残疾的长期影响。:这项单中心队列研究纳入了接受出院后立即进行急性康复干预的重症COVID-19患者。三年后,通过电话使用WHODAS 2.0问卷对患者进行评估。在医院数据库中识别出的69名患者中,27名做出了回应。共有16名患者因情绪困扰拒绝回应。平均年龄为63.4±8.6岁,81.5%的患者在社区中独立生活,55.3%的患者此前曾入住重症监护病房(ICU),康复住院时间中位数为18(11.5,24)天。合并症包括2型糖尿病(DM)(55.5%)、2级高血压(62.9%)、压疮(37%)、周围神经功能缺损(62.9%)和中枢神经功能缺损(14.8%)。入住ICU与更高的康复需求(以康复水平衡量(<0.01))和更长的住院时间(以住院总天数衡量(<0.001))显著相关。总体残疾评分为35.09%,受DM和中枢神经功能缺损的显著影响。中枢神经功能缺损和DM与更高的残疾评分相关。定制的康复计划、持续的医学评估、综合护理模式和患者教育对于改善COVID-19疾病后的长期预后至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fc5/11355617/fb9f8b05f951/jcm-13-04694-g001.jpg

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