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Changes in quality of life and dyspnoea after hospitalization in COVID-19 patients discharged at home.

ABSTRACT: Background:To date, the effects of COVID-19 pneumonia on health-related quality of life (HRQoL) and dyspnoea are unknown. Methods:In a real-life observational study, 20 patients with COVID-19-related pneumonia received usual care plus erdosteine (300 mg twice daily) for 15 days after hospital discharge following local standard operating procedures. At discharge (T0) and on Day 15 (T1), participants completed the St George's Respiratory Questionnaire (SGRQ), the modified Medical Research Council (mMRC) scale of dyspnoea during daily activity, the BORG scale for dyspnoea during exertion, and Visual Analogue Scale (VAS) for dyspnoea at rest. Paired t-tests compared scores at T0 and T1. Results:The mean (SD) SGRQ total score decreased from 25.5 (15.5) at T0 to 16.9 (13.2) at T1 (p<0.01); 65% of patients achieved a clinically important change of ?4 points. SGRQ domain scores (symptoms, activity, and impact) were also significantly reduced (all p<0.01). The mean (SD) VAS score decreased from 1.6 (1.7) to 1.4 (2.5); p<0.01. The mean mMRC score decreased significantly (p=0.031) and 30% of patients achieved a clinically important change of ?1 point. The mean (SD) Borg score increased from 12.8 (4.2) to 14.3 (2.4); p<0.01. Conclusion:The present proof of concept study is the first to report HRQoL in patients with COVID-19. During 15 days after hospital discharge, patients reported significant improvements in HRQoL and dyspnoea at rest and during daily activities.

SUBMITTER: Santus P

PROVIDER: S-EPMC7582021 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Changes in quality of life and dyspnoea after hospitalization in COVID-19 patients discharged at home.

Santus Pierachille P Tursi Francesco F Croce Giuseppe G Di Simone Chiara C Frassanito Francesca F Gaboardi Paolo P Airoldi Andrea A Pecis Marica M Negretto Giangiuseppe G Radovanovic Dejan D

Multidisciplinary respiratory medicine 20200101 1

<h4>Background</h4>To date, the effects of COVID-19 pneumonia on health-related quality of life (HRQoL) and dyspnoea are unknown.<h4>Methods</h4>In a real-life observational study, 20 patients with COVID-19-related pneumonia received usual care plus erdosteine (300 mg twice daily) for 15 days after hospital discharge following local standard operating procedures. At discharge (T0) and on Day 15 (T1), participants completed the St George's Respiratory Questionnaire (SGRQ), the modified Medical Re ...[more]

PMID: 33117535

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Project description:IntroductionEDs are often the first line of contact with individuals infected with COVID-19 and play a key role in triage. However, there is currently little specific guidance for deciding when patients with COVID-19 require hospitalisation and when they may be safely observed as an outpatient.MethodsIn this retrospective study, we characterised all patients with COVID-19 discharged home from EDs in our US multisite healthcare system from March 2020 to August 2020, focusing on individuals who returned within 2 weeks and required hospital admission. We restricted analyses to first-encounter data that do not depend on laboratory or imaging diagnostics in order to inform point-of-care assessments in resource-limited environments. Vitals and comorbidities were extracted from the electronic health record. We performed ordinal logistic regression analyses to identify predictors of inpatient admission, intensive care and intubation.ResultsOf n=923 patients who were COVID-19 positive discharged from the ED, n=107 (11.6%) returned within 2 weeks and were admitted. In a multivariable-adjusted model including n=788 patients with complete risk factor information, history of hypertension increased odds of hospitalisation and severe illness by 1.92-fold (95% CI 1.07 to 3.41), diabetes by 2.20-fold (1.18 to 4.02), chronic lung disease by 2.21-fold (1.22 to 3.92) and fever by 2.89-fold (1.71 to 4.82). Having at least two of these risk factors increased the odds of future hospitalisation by 6.68-fold (3.54 to 12.70). Patients with hypertension, diabetes, chronic lung disease or fever had significantly longer hospital stays (median 5.92 days, 3.08-10.95 vs 3.21, 1.10-5.75, p<0.01) with numerically higher but not significantly different rates of intensive care unit admission (27.02% vs 14.30%, p=0.27) and intubation (12.16% vs 7.14%, p=0.71).DiscussionPatients infected with COVID-19 may appear clinically safe for home convalescence. However, those with hypertension, diabetes, chronic lung disease and fever may in fact be only 'pseudo-safe' and are most at risk for subsequent hospitalisation with more severe illness and longer hospital stays.

Project description:The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) virus initially appeared in Wuhan, Hubei Province, China has caused a novel coronavirus disease (COVID-19) [1]. The disease is rapidly spread around the world causing thousands of deaths and posing critical challenges for public health and clinical research in the world. The outbreak was declared by the World Health Organization (WHO) as a public health emergency of international concern. Nowadays, there are more than 18 millions of confirmed cases of coronavirus across the world with a total of 702,903 deaths [2]. In Morocco, there are 28,500 confirmed cases and 345 deaths. Forecasts for the cumulative number of confirmed, recovered, active and death cases were recently provided [3]. To manage the pandemic spread several countries adopted proactive and preventive measures including home confinement of the population. However, there is evidence that these measures, particularly home confinement, can cause unprecedented disruption in the well-being of the population. Being forced to stay at home and the daily activities' restrictions could impact the citizens' health-related quality of life (HRQoL) and behavior-related lifestyle. It has been reported that the COVID-19 pandemic has an impact on psychological behaviors [4], mental health [5] and anxiety/depression [6]. The Moroccan population was under home confinement from March 20, 2020. Assessing rapidly and simply the HRQoL during crisis such as the home confinement is a challenge of interest to provide speedy information to authorities which allow best management of damages yielding in crisis situation. The EQ-5D instrument is a generic questionnaire developed by the Euroqol group for measuring the HRQoL by combining five health dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) [7]. The EQ-5D instrument is translated into more than 300 languages and exhibit good reliability and validity in both patients and general population. Herein, we used the EQ-5D-5L instrument to assess for the first time the impact of the home confinement on the HRQoL. Also, we evaluated the changes in behaviors by asking some questions related to lifestyle before and during the home confinement. These data can help the Moroccan authorities and other countries to more understand the impact of this crisis on citizens and therefore to set up adequate protocols for managing the post-confinement or possible future crisis. We provided two datasets: (1) data we collected before confinement from a sample of 484 individuals describing their HRQoL [8] and (2) data we collected during the home confinement period from a sample of 537 individuals describing their HRQoL and behavior-related lifestyle.

Dataset Information

Changes in quality of life and dyspnoea after hospitalization in COVID-19 patients discharged at home.

Publications

Changes in quality of life and dyspnoea after hospitalization in COVID-19 patients discharged at home.

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