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. 2021 Aug:184:106453.
doi: 10.1016/j.rmed.2021.106453. Epub 2021 May 13.

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

Beatriz Costa Todt  1 , Claudia Szlejf  2 , Etienne Duim  3 , Alana O M Linhares  4 , Diogo Kogiso  4 , Gabriela Varela  4 , Bruna A Campos  4 , Cristina Mara Baghelli Fonseca  4 , Leonardo E Polesso  4 , Ingra N S Bordon  4 , Bruno T Cabral  4 , Victor L P Amorim  5 , Felipe M T Piza  6 , Luiza Helena Degani-Costa  7
Affiliations

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

Beatriz Costa Todt et al. Respir Med. 2021 Aug.

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.

Keywords: COVID-19; Critical care; Quality of life.

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Conflict of interest statement

The authors have no conflict of interest to declare.

Figures

Fig. 1
Fig. 1
Sample flow chart. The figure displays a visual guide of the eligible patients admitted at the secondary medical care hospital for treatment for COVID-19 and the final sample that survived and accepted to participate in the cohort study.
Fig. 2
Fig. 2
Dimensions of quality of life pre and post COVID-19 infection. The figure presents the percentual of individuals with some problem (2 or more points in EQ-5D questionnaire) in each dimension of quality of life before the onset of COVID-19 symptoms and at 3-months following discharge according to sex. Graphics range: [0%–65%].
See this image and copyright information in PMC

References

    1. Zhu N., Zhang D., Wang W., Li X., Yang B., Song J., et al. A novel coronavirus from patients with pneumonia in China, 2019. N. Engl. J. Med. 2020;382(8):727–733. - PMC - PubMed
    1. Wiersinga W.J., Rhodes A., Cheng A.C., Peacock S.J., Prescott H.C. Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19): a review. J. Am. Med. Assoc. 2020;324(8):782–793. - PubMed
    1. Huang C., Wang Y., Li X., Ren L., Zhao J., Hu Y., et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497–506. 10223. - PMC - PubMed
    1. George P.M., Barratt S.L., Condliffe R., Desai S.R., Devaraj A., Forrest I., et al. Respiratory follow-up of patients with COVID-19 pneumonia. Thorax. 2020;75(11):1009–1016. - PubMed
    1. Carvalho-Schneider C., Laurent E., Lemaignen A., Beaufils E., Bourbao-Tournois C., Laribi S., et al. Follow-up of adults with non-critical COVID-19 two months after symptoms’ onset. Clin. Microbiol. Infect. 2021;27(2):258–263. - PMC - PubMed