COVID-19 Healthcare Access and Sequelae Evaluation

项目总结

PROJECT SUMMARY Emerging data suggest that COVID-19 survivors will experience long-lasting physical, cognitive, and mental health sequelae, similar to non-COVID-19 sepsis survivors. However, COVID-19 may also cause specific sequelae that result from unique aspects of the SARS-CoV-2 infection. Currently, data comparing long-term outcomes for COVID-19 vs non-COVID-19 sepsis survivors are lacking. Our prior work has shown that a multicomponent transitional care strategy after sepsis discharge improves health outcomes for sepsis survivors. However, several factors, including distancing requirements and healthcare-related stigma, discrimination, or refusal of care challenge the delivery of optimal transitional support for survivors of COVID-19. The extent to which COVID-19 sepsis survivors have restricted access to transitional support after discharge and the long-term functional, cognitive, and mental health sequelae of COVID- 19-related sepsis are unknown. The central goal of the COVID-19 Healthcare Access and Sequelae Evaluation (CHASE) study is to advance knowledge of post-illness deficits and challenges experienced by survivors of COVID-19-related sepsis and inform delivery of post- sepsis transitional care to improve outcomes for both COVID-19 and non-COVID-19 sepsis survivors. To achieve this goal, we will leverage the strengths of our ongoing pragmatic trial of sepsis survivors (R01NR018434) to enable efficient and representative recruitment of patients for focused data collection and longitudinal assessment of patients with COVID-19 sepsis and a comparison group of patients with non-COVID-19 sepsis. We will evaluate a core outcomes measure set of long-term outcomes at 90- and 180-days (AIM 1), assess COVID-19-related limitations to accessing pivotal post-discharge healthcare support (AIM 2), and explore if the effects of our novel sepsis transition and recovery (STAR) program, delivered virtually through a nurse navigator, are generalizable to COVID-19 survivors (AIM 3). We hypothesize that COVID- 19 sepsis survivors will experience poorer long-term outcomes and more restricted access to post-discharge care compared to non-COVID-19 sepsis survivors. Our proposal capitalizes on the existing infrastructure, trial cohort, and data collection of the parent award as an efficient approach to achieving our aims with limited additional time and cost. Findings from the CHASE study will provide key information to health systems on specific challenges experienced by COVID-19 sepsis survivors and the utility of STAR, a scalable, virtually integrated transition program, to improve outcomes for sepsis survivors with and without COVID-19.