Bek Martine, Türk Yasemin, Janssen Matthijs L, Weijsters Gemma, Berentschot Julia C, van den Berg-Emons Rita J G, Heijenbrok-Kal Majanka H, Ribbers Gerard M, Aerts Joachim, Hanselaar Wessel E J J, Endeman Henrik, Hellemons Merel E, Wils Evert-Jan
Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
Department of Respiratory Medicine, Franciscus Gasthuis & Vlietland Hospital, Rotterdam, The Netherlands.
BMJ Open Respir Res. 2025 Jun 8;12(1):e002789. doi: 10.1136/bmjresp-2024-002789.
To investigate the association between COVID-19 disease severity during hospitalisation for COVID-19 and long-term multidimensional patient-centred outcomes up to 12 months post-hospitalisation. The secondary objective was to identify other risk factors for these long-term outcomes.
In this multicentre prospective cohort study, we categorised COVID-19 disease severity using the maximal level of respiratory support as proxy into (1) conventional oxygen therapy (COT), (2) high-flow nasal oxygen (HFNO) and (3) invasive mechanical ventilation (IMV). The primary outcome health-related quality of life (HRQoL), and the secondary outcomes self-reported symptoms and recovery were collected at 6 and 12 months post-hospitalisation.
Data from 777 patients were analysed, with 226 (29%) receiving COT, 273 (35%) HFNO and 278 (36%) IMV. Patients reported impaired HRQoL, persistence of symptoms and poor recovery. Multivariable generalised estimating equations analysis showed that COVID-19 disease severity was not associated with HRQoL and inconsistently with symptoms; the HFNO group reported poorer recovery. Overall, female sex, younger age and pulmonary history were independent risk factors for outcomes.
COVID-19 disease severity was associated with self-perceived recovery, but not with HRQoL and inconsistently with symptoms. Our findings suggest that age, sex and pulmonary history are more consistent risk factors for long-term multidimensional outcomes and offer better guidance for aftercare strategies.
研究新型冠状病毒肺炎（COVID-19）住院期间疾病严重程度与出院后长达12个月的以患者为中心的长期多维结局之间的关联。次要目的是确定这些长期结局的其他风险因素。
在这项多中心前瞻性队列研究中，我们将COVID-19疾病严重程度以呼吸支持的最高水平作为替代指标分为：（1）传统氧疗（COT），（2）高流量鼻导管吸氧（HFNO）和（3）有创机械通气（IMV）。在出院后6个月和12个月收集主要结局指标健康相关生活质量（HRQoL）以及次要结局指标自我报告的症状和恢复情况。
分析了777例患者的数据，其中226例（29%）接受COT，273例（35%）接受HFNO，278例（36%）接受IMV。患者报告HRQoL受损、症状持续且恢复不佳。多变量广义估计方程分析表明，COVID-19疾病严重程度与HRQoL无关，与症状的相关性不一致；HFNO组报告恢复较差。总体而言，女性、年轻和肺部病史是结局的独立危险因素。
COVID-19疾病严重程度与自我感知的恢复有关，但与HRQoL无关，与症状的相关性不一致。我们的研究结果表明，年龄、性别和肺部病史是长期多维结局更一致的危险因素，并为后续护理策略提供了更好的指导。
