Six-Month Outcomes in Patients Hospitalized with Severe COVID-19.
Six-Month Outcomes in Patients Hospitalized with Severe COVID-19.
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DOI：
10.1007/s11606-021-07032-9
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发表时间：
2021-12
影响因子：
5.7
通讯作者：
Weerahandi H
中科院分区：
文献类型：
--
作者：
Horwitz LI;Garry K;Prete AM;Sharma S;Mendoza F;Kahan T;Karpel H;Duan E;Hochman KA;Weerahandi H
先前的研究表明，患者在COVID-19住院后出院后1-3个月出现功能下降。为了确定症状是否会进一步持续或随着时间的推移而改善，我们对重症COVID-19住院后出院的患者进行了随访，以表征他们出院后6个月的整体健康状况和身心健康状况。前瞻性观察队列研究。在单一卫生系统因COVID-19住院≥18年的患者，入院时需要至少6l的补充氧，基线功能状态完好，出院时存活。总体健康状况、身体健康、心理健康和呼吸困难通过有效的调查进行评估：PROMIS®Global health -10和PROMIS®呼吸困难特征工具。152例患者完成了出院后1个月的调查，126例（83%）完成了6个月的调查。6个月受访者的中位年龄为62岁；40%是女性。93例（74%）患者报告他们的健康在6个月时没有恢复到基线水平，平均7.1个症状。6个月时，参与者在身体健康和精神健康领域的总t得分（分别为45.2，标准差[SD] 9.8; 47.4, SD 9.8）仍低于基线（身体健康53.7,SD 9.4；精神健康54.2,SD 8.0, p<0.001）。总体而言，79名（63%）患者在前一周报告呼吸短促（中位数得分为2分（四分位数范围[IQR] 0 - 5），而42名（33%）患者在covid -19感染前（0,IQR 0 -1））。共有11/124（9%）患者在出院后6个月仍需吸氧。107例（85%）在出院后6个月仍感到疲劳。即使在出院6个月后，大多数患者报告他们的健康仍未恢复正常。迫切需要支持和治疗，使这些患者恢复到covid - 19前的基线水平。在线版本包含补充资料，下载地址：10.1007/s11606-021-07032-9。
Previous work has demonstrated that patients experience functional decline at 1–3 months post-discharge after COVID-19 hospitalization. To determine whether symptoms persist further or improve over time, we followed patients discharged after hospitalization for severe COVID-19 to characterize their overall health status and their physical and mental health at 6 months post-hospital discharge. Prospective observational cohort study. Patients ≥ 18 years hospitalized for COVID-19 at a single health system, who required at minimum 6 l of supplemental oxygen during admission, had intact baseline functional status, and were discharged alive. Overall health status, physical health, mental health, and dyspnea were assessed with validated surveys: the PROMIS® Global Health-10 and PROMIS® Dyspnea Characteristics instruments. Of 152 patients who completed the 1 month post-discharge survey, 126 (83%) completed the 6-month survey. Median age of 6-month respondents was 62; 40% were female. Ninety-three (74%) patients reported that their health had not returned to baseline at 6 months, and endorsed a mean of 7.1 symptoms. Participants’ summary t-scores in both the physical health and mental health domains at 6 months (45.2, standard deviation [SD] 9.8; 47.4, SD 9.8, respectively) remained lower than their baseline (physical health 53.7, SD 9.4; mental health 54.2, SD 8.0; p<0.001). Overall, 79 (63%) patients reported shortness of breath within the prior week (median score 2 out of 10 (interquartile range [IQR] 0–5), vs 42 (33%) pre-COVID-19 infection (0, IQR 0–1)). A total of 11/124 (9%) patients without pre-COVID oxygen requirements still needed oxygen 6 months post-hospital discharge. One hundred and seven (85%) were still experiencing fatigue at 6 months post-discharge. Even 6 months after hospital discharge, the majority of patients report that their health has not returned to normal. Support and treatments to return these patients back to their pre-COVID baseline are urgently needed. The online version contains supplementary material available at 10.1007/s11606-021-07032-9.
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