Care Dependency in Non-Hospitalized Patients with COVID-19.

Anouk W Vaes,Maarten Van Herck,Yvonne Spies,Roy Meys,Martijn A Spruit,Felipe V.C Machado,Jeannet M Delbressine,Alex J Van ’T Hul,Yvonne M.J Goertz,Daisy J.A Janssen,Chris Burtin,Frits M.E Franssen,Sarah Houben-Wilke,Herman Vijlbrief

doi:10.3390/jcm9092946

Abstract

Background: A large sample of “mild” COVID-19 patients still experience multiple symptoms months after being infected. These persistent symptoms are associated with many clinically relevant outcomes, including poor health status and impaired functional status. To date, no information is available about care dependency. Therefore, we aimed to explore the level of care dependency and the need for assistance with personal care in non-hospitalized COVID-19 patients. Methods: Members of two Facebook groups for COVID-19 patients with persistent complaints in The Netherlands and Belgium, and from a panel of people who registered at a website of the Lung Foundation Netherlands, were assessed for demographics, pre-existing comorbidities, health status, and symptoms. In addition, patients were asked about their dependence on others for personal care before and after the infection. The level of care dependency was assessed with the Care Dependency Scale (CDS) in members of the Belgian Facebook group (n = 210). Results: The data of 1837 non-hospitalized patients (86% women; median (IQR) age: 47 (38–54)) were analyzed. Only a small proportion of patients needed help with personal care before COVID-19, but the care need increased significantly after the infection (on average 79 ± 17 days after the onset of symptoms; 7.7% versus 52.4%, respectively; p < 0.05). The patients had a median (IQR) CDS score of 72 (67–75) points, and 31% of the patients were considered as care-dependent (CDS score ≤ 68 points). Conclusions: COVID-19 has an important impact on care dependency in non-hospitalized patients. About three months after the onset of symptoms, a considerable proportion of non-hospitalized patients were to some degree dependent on others for personal care. This indicates that the impact of COVID-19 on patients’ daily lives is tremendous, and more attention is needed to identify optimal treatment strategies to restore patients’ independency.

Highlights

Since the beginning of the worldwide outbreak of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), most studies have focused on hospitalized patients with severe coronavirus disease 2019 (COVID-19)
As part of a large cross-sectional study conducted in The Netherlands and Flanders (Belgium), an online questionnaire was made available between 4 June and 11 June 2020 to all members of two Facebook groups for coronavirus patients with persistent complaints in The Netherlands (~11,000 members: “Corona ervaringen en langdurige klachten!”) [6] and Flanders (~1200 members: “Corona patiënten met langdurige klachten (Vlaanderen)”) [7], and to a panel of ~1200 people who registered at a website of the Lung Foundation Netherlands for additional information regarding COVID-19
Data from 220 respondents were excluded, as they were admitted to an intensive care unit (ICU) (n = 15), gender was not reported (n = 9), the onset of symptoms was before 1 January 2020, the onset of symptoms was less than three weeks ago (n = 14), or the survey was incomplete (n = 174)

Summary

Introduction

Since the beginning of the worldwide outbreak of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), most studies have focused on hospitalized patients with severe coronavirus disease 2019 (COVID-19). Goërtz and colleagues were the first to highlight the unmet healthcare needs of a large group of non-hospitalized COVID-19 patients [3] They demonstrated that about three months after the infection, a large sample of COVID-19 patients still experienced multiple symptoms, providing evidence for a post-COVID-19 syndrome [3]. The aim of this study was to explore the level of care dependency in ADLs and the need for assistance with personal care in non-hospitalized COVID-19 patients. About three months after the onset of symptoms, a considerable proportion of non-hospitalized patients were to some degree dependent on others for personal care This indicates that the impact of COVID-19 on patients’ daily lives is tremendous, and more attention is needed to identify optimal treatment strategies to restore patients’ independency

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