The COVID-19 Sequelae: A Cross-Sectional Evaluation of Post-recovery Symptoms and the Need for Rehabilitation of COVID-19 Survivors.
The COVID-19 Sequelae: A Cross-Sectional Evaluation of Post-recovery Symptoms and the Need for Rehabilitation of COVID-19 Survivors.
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DOI：
10.7759/cureus.13080
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发表时间：
2021-02-02
期刊：
影响因子：
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通讯作者：
Raza M
中科院分区：
文献类型：
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作者：
Iqbal A;Iqbal K;Arshad Ali S;Azim D;Farid E;Baig MD;Bin Arif T;Raza M
背景截至2021年1月19日，地球仪已报告约200万人死于2019冠状病毒病（COVID-19），6800万人康复。过去的严重急性呼吸综合征（SARS）和中东呼吸综合征（MERS）大流行暗示了发生"长冠状病毒"综合征的风险，即，COVID-19幸存者出院后症状的持续存在。由于缺乏关于COVID-19后表现的文献，并且很少考虑与这种疾病相关的耻辱，幸存者的康复仍然被广泛忽视。本研究旨在评估COVID-19后表现的患病率和特征及其对COVID-19康复者生活质量（QoL）的影响。我们还分析了COVID-19恢复后的时间及其严重程度与出院后症状的关系。与SARS冠状病毒-2（SARS-CoV-2）感染相关的耻辱也得到了强调。方法于2020年9月至2020年12月在158名COVID-19康复患者中进行了一项描述性、横断面、基于药物的研究，其信息来自巴基斯坦卡拉奇Ojha Campus的Dow诊断实验室。问卷包括四个部分：社会人口学数据、COVID-19后表现、与耻辱相关的问题以及COVID-19康复患者的生活质量。我们使用EuroQol五维五级问卷评估QoL，而2019年更新的修改后的BG Prasad社会经济分类用于确定参与者的社会经济地位。使用SPSS 24.0版（IBM Corp.，美国纽约州阿尔蒙克）。数据以频率和百分比的形式呈现。结果绝大多数（94.9%）患者在COVID-19后出现至少一种症状，其中疲劳（82.9%）是最常见的出院后症状。我们观察到COVID-19后的症状与性别、年龄和康复时间显著相关。发现COVID-19严重程度与生活质量的五个维度显著相关。在轻度、中度和重度COVID-19感染的参与者之间观察到EuroQol视觉模拟量表健康评分的显著差异（p <0.001）。此外，与SARS-CoV-2感染相关的耻辱感在上层社会的参与者中比其他阶层更普遍（p <0.05）。尽管如此，我们也观察到疾病严重程度与COVID-19后表现和既存合并症显著相关。结论长期COVID综合征与SARS和MERS大流行幸存者的出院后表现相似。多学科康复团队、医护人员和普通人群应认识到有必要对他们的康复和进一步康复进行系统评估。
Background As of January 19, 2021, around two million fatalities and 68 million recoveries from coronavirus disease 2019 (COVID-19) have been reported around the globe. The past pandemics of severe acute respiratory syndrome (SARS) and the Middle East respiratory syndrome (MERS) hint toward a risk of occurrence of "Long-COVID" syndrome, i.e., the persistence of post-discharge symptoms among COVID-19 survivors. With the scarcity of literature addressing post-COVID-19 manifestations and little regard for the stigma associated with this disease, survivors' rehabilitation remains widely neglected. The current study aims to assess the prevalence and characteristics of post-COVID-19 manifestations and their effect on the quality of life (QoL) of COVID-19 recovered individuals. We have also analyzed the relationship of time since the recovery of COVID-19 and its severity with the post-discharge symptoms. The stigma affiliated with the infection of SARS coronavirus-2 (SARS-CoV-2) has also been highlighted. Methodology A descriptive, cross-sectional, questionnaire-based study was conducted from September 2020 to December 2020 among 158 COVID-19 recovered patients, whose information was obtained from Dow Diagnostic Laboratory, Ojha Campus, Karachi, Pakistan. The questionnaire consisted of four sections: sociodemographic data, post-COVID-19 manifestations, questions relating to the stigma, and the QoL of the recovered COVID-19 patients. We used the EuroQol five-dimension five-level questionnaire to assess the QoL, while the modified BG Prasad Socioeconomic Classification updated for 2019 was employed to determine the socioeconomic status of the participants. Data were analyzed using SPSS version 24.0 (IBM Corp., Armonk, NY, USA). Data were presented in the form of frequencies and percentages. Results An overwhelming majority (94.9%) experienced at least one post-COVID-19 symptom, with fatigue (82.9%) being the most prevalent post-discharge manifestation. We observed a significant correlation of post-COVID-19 symptoms with gender, age, and time since recovery. COVID-19 severity was found to be significantly related to the five dimensions of the QoL. A significant difference in EuroQol Visual Analog Scale health score was observed between the participants with mild, moderate, and severe COVID-19 infection (p < 0.001). Besides, the associated stigma with SARS-CoV-2 infection was found to be more prevalent in the participants belonging to the upper class as compared to the other classes (p < 0.05). Nonetheless, we also observed a significant association of disease severity with post-COVID-19 manifestations and pre-existing comorbidities. Conclusions The long-COVID syndrome is similar to the post-discharge manifestations of the survivors of prior pandemics of SARS and MERS. Multi-disciplinary rehabilitation teams, healthcare workers, and the general population should recognize the need for systematic assessment of their recovery and further rehabilitation.