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Clinical outcomes and quality of life of COVID-19 survivors: A follow-up of 3 months post hospital discharge - 11/06/21

Doi : 10.1016/j.rmed.2021.106453 
Beatriz Costa Todt a, Claudia Szlejf b, Etienne Duim c, Alana O.M. Linhares d, Diogo Kogiso d, Gabriela Varela d, Bruna A. Campos d, Cristina Mara Baghelli Fonseca d, Leonardo E. Polesso d, Ingra N.S. Bordon d, Bruno T. Cabral d, Victor L.P. Amorim d, f, Felipe M.T. Piza d, e, Luiza Helena Degani-Costa f,
a Internal Medicine Residency Program, Hospital Israelita Albert Einstein, Brazil 
b Department of Big Data, Hospital Israelita Albert Einstein, Brazil 
c Department of Diagnostic and Ambulatory Medicine, Hospital Israelita Albert Einstein, Brazil 
d Hospital Municipal Dr. Moysés Deutsch, Brazil 
e Intensive Care Unit, Hospital Israelita Albert Einstein, Brazil 
f Faculdade Israelita de Ciências da Saúde Albert Einstein, Internal Medicine Department, Hospital Israelita Albert Einstein, Brazil 

Corresponding author. Internal Medicine Department, Hospital Israelita Albert Einstein, Sao Paulo, SP, Brazil.Internal Medicine DepartmentHospital Israelita Albert EinsteinSao PauloSPBrazil

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Abstract

Background

Over 66 million people worldwide have been diagnosed with COVID-19. Therefore, understanding their clinical evolution beyond hospital discharge is essential not only from an individual standpoint, but from a populational level.

Objectives

Our primary aim was to assess the impact of COVID-19 on health-related quality of life (HRQoL) 3 months after hospital discharge. Additionally, we screened for anxiety and depression and assessed important clinical outcomes.

Methods

This was a single-center cohort study performed in Sao Paulo (Brazil), in which participants were contacted by telephone to answer a short survey. EQ-5D-3L was used to assess HRQoL and clinical data from patients’ index admission were retrieved from medical records.

Results

We contacted 251 participants (59.8% males, mean age 53 years old), 69.7% of which had presented with severe COVID-19. At 3 months of follow-up, 6 patients had died, 51 (20.3%) had visited the emergency department again and 17 (6.8%) had been readmitted to hospital. Seventy patients (27.9%) persisted with increased dyspnoea and 81 had a positive screening for anxiety/depression. Similarly, patients reported an overall worsening of EQ-5D-3L single summary index at 3 months compared to before the onset of COVID-19 symptoms (0.8012 (0.7368 – 1.0) vs. 1.0(0.7368 – 1.0), p < 0.001). This affected all 5 domains, but especially pain/discomfort and anxiety/depression. Only female sex and intensive care requirement were independently associated with worsening of HRQoL.

Conclusion

Patients hospitalized for COVID-19 frequently face persistent clinical and mental health problems up to 3 months following hospital discharge, with significant impact on patients’ HRQoL.

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Highlights

COVID-19 admission is associated with persistent clinical and mental health problems.
Dyspnoea persists up to 3 months following hospital discharge in many patients.
HRQoL is significantly worsened up to 3 months following hospital discharge.
Pain/discomfort and anxiety/depression were the most impacted domains of HRQoL.
Female sex and intensive care requirement were associated with worsening of HRQoL.

Le texte complet de cet article est disponible en PDF.

Keywords : COVID-19, Quality of life, Critical care


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Vol 184

Article 106453- août 2021 Retour au numéro
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