2019年冠状病毒病住院后的身体、心理和认知结果:一项对巴西队列进行3个月随访的前瞻性研究

Victor Figueiredo Leite, Leandro Gonçalves Cezarino, Valéria Conceição Jorge, Maria do Carmo Correia de Lima, Cleber Nunes da Rocha, Silmara Scontre, Danielle Bianchini Rampim
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摘要

背景:冠状病毒后疾病(COVID)与多种损伤相关。目的:了解COVID-19住院治疗的后果及出院后3个月功能依赖的危险因素。环境与设计:纵向医疗保健网络中的前瞻性队列研究。材料和方法:对2020年6月至11月因COVID-19住院的个体进行调查,评估基线时以及1个月和3个月后的身体和呼吸症状、心理健康、身体、吞咽和声带以及认知功能的相关结果。将重症监护病房的患者与普通病房的患者进行比较。使用的统计分析:组内、组间比较和跨时间点使用T检验配对样本,Wilcoxon检验,单因素方差分析和Kruskal-Wallis, Pearson χ 2和Fisher精确检验,统计能力为80%,α = 5%,以及事后单变量和多变量逻辑回归。结果:参与者(n = 326)的平均年龄为70.3(9.2)岁,住院时间中位数(四分位数间距)为5(3-8)天。在3个月的随访中,参与者持续出现疲劳(64.7%)、呼吸困难(44.5%)、疼痛(18.5%)。在同一时期,呼吸困难和疲劳率恶化。多变量回归显示,出院时time Up和Go (test)≥20秒可作为3个月随访时IADL功能依赖的预测因子[优势比=3.12 (95% CI: 1.25-7.84)]。结论:COVID-19的影响持续了至少3个月,期间只有部分结果有所改善。在基线的Timed Up and Go测试中表现不佳是3个月时功能依赖的预测指标。
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Physical, psychological, and cognitive outcomes after coronavirus disease 2019 hospitalization: a prospective study with 3-month follow-up of a Brazilian cohort
Context: Post–coronavirus disease (COVID) is associated with multiple impairments. Aims: To identify consequences of COVID 2019 (COVID-19) hospitalization, and risk factors for functional dependence 3 months after discharge. Settings and design: Prospective cohort in a verticalized health care network. Material and methods: Individuals hospitalized from June to November 2020 due to COVID-19 were investigated assessing outcomes pertaining to physical and respiratory symptoms, mental health, and physical, swallow and vocal, and cognitive function at baseline, and after 1 and 3 months. Those admitted to the intensive care unit were compared with those in the ward. Statistical analysis used: Within and between-group comparison and across time points using T test paired samples, Wilcoxon test, 1-way analysis of variance and Kruskal-Wallis, Pearson χ 2 and Fisher exact test, with a statistical power of 80% and α = 5%, and a post hoc univariable and multivariable logistic regression. Results: Participants (n = 326) had a mean of 70.3 (9.2) years and were hospitalized for a median (interquartile range) of 5 (3–8) days. In the 3-month follow-up, participants persisted with fatigue (64.7%), breathlessness (44.5%), aches, and pains (18.5%). Dyspnea and fatigue rates worsened during the same time period. Multivariable regression showed Timed Up and Go (test) ≥20 seconds at discharge as a predictor of functional dependence for IADL at the 3-month follow-up [odds ratio =3.12 (95% CI: 1.25–7.84)]. Conclusions: The impact of COVID-19 persisted for at least 3 months, with improvement of only some outcomes in the period. A poor performance at the Timed Up and Go test at baseline was a predictor of functional dependence at 3 months.
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