Abstract
Background: We aimed to longitudinally monitor the recovery in breathlessness, symptom burden, health-related quality-of-life, and mental health status in individuals hospitalised due to SARS-CoV-2 associated respiratory failure.Methods: Individuals hospitalised due to SARS-CoV-2 associated respiratory failure were recruited at hospital discharge in three participating centres. During the 90 day follow-up, European Quality of Life−5 Dimensions−5 Levels Instrument (EQ-5D-5L), modified Medical Research Council (mMRC) Dyspnoea Scale, COPD Assessment Test (CAT), and weekly Hospital Anxiety and Depression Scale (HADS) questionnaires were assessed using a smartphone application. The results were presented using descriptive statistics and graphics. Linear mixed models with random intercept were fitted to analyse differences of intensive-care unit status on the recovery course in each outcome.Results: We included 58 participants, 40 completed the study. From hospital discharge until 90 days post-discharge, EQ-5D-5L index changed from 0.83 (0.66, 0.92) to 0.96 (0.82, 1.0), VAS rating on general health status changed from 62 (50, 75) % to 80 (74, 94) %, CAT changed from 13 (10, 21) to 7 (3, 11) points, mMRC changed from 1 (0, 2) to 0 (0, 1) points, HADS depression subscale changed from 6 (4, 9) to 5 (1, 6) points, HADS anxiety subscale changed from 7 (3, 9) to 2 (1, 8) points. Differences in the recovery courses were observed between intensive-care and ward participants. Participants that were admitted to an intensive-care unit during their hospitalisation (n = 16) showed increases in CAT, mMRC, HADS scores, and decreases in EQ-5D-5L 30 days after hospital discharge.Conclusion: Being admitted to an ICU led to statistically significant reductions in recovery in the EQ-5D-5L and the CAT. Furthermore, the flare-up in symptom burden and depression scores, accompanied by an attenuated recovery in HrQoL and general health status in the ICU-group suggests that a clinical follow-up 1 month after hospital discharge can be recommended, evaluating further treatments.Clinical Trial Registration: [www.ClinicalTrials.gov], identifier [NCT04365595].
Highlights
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) is the cause of the current pandemic of coronavirus disease (COVID-19) that can lead to respiratory failure requiring oxygen therapy (1)
From hospital discharge until 90 days post-discharge, EQ-5D-5L index changed from 0.83 (0.66, 0.92) to 0.96 (0.82, 1.0), visual analogue scale (VAS) rating on general health status changed from 62 (50, 75) % to 80 (74, 94) %, COPD Assessment Test (CAT) changed from 13 (10, 21) to 7 (3, 11) points, modified Medical Research Council (mMRC) changed from 1 (0, 2) to 0 (0, 1) points, Hospital Anxiety and Depression Scale (HADS) depression subscale changed from 6 (4, 9) to 5 (1, 6) points, HADS anxiety subscale changed from 7 (3, 9) to 2 (1, 8) points
Participants that were admitted to an intensive-care unit during their hospitalisation (n = 16) showed increases in CAT, mMRC, HADS scores, and decreases in EQ-5D-5L 30 days after hospital discharge
Summary
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) is the cause of the current pandemic of coronavirus disease (COVID-19) that can lead to respiratory failure requiring oxygen therapy (1). Information on the recovery in breathlessness, symptom burden, mental health status, and on self-perceived recovery may help to provide individually tailored healthcare. Some evidence on these patient-centred parameters is available (6–10). Three of these studies used paper-based questionnaires; one covering the acute disease stage from first symptoms until the release from quarantine measures (8), a second assessing HrQoL 6 weeks after hospital discharge for a COVID-19 pneumonia (7), and a third large-scale multi-centre trial followed-up 2–7 months after hospital discharge (10). We aimed to longitudinally monitor the recovery in breathlessness, symptom burden, health-related quality-of-life, and mental health status in individuals hospitalised due to SARS-CoV-2 associated respiratory failure
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