与 COVID-19 幸存者生活质量和持续呼吸困难严重程度相关的因素:一项针对医护人员的横断面研究

Narra J Pub Date : 2023-11-24 DOI:10.52225/narra.v3i3.419
J. P. Sinaga, B. Y. Sinaga, P. Siagian, P. Eyanoer, I. M. Unata
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引用次数: 0

摘要

冠状病毒病 2019(COVID-19)大流行对全球健康产生了重大影响。大流行期间和之后,生活质量(QoL)的改变和持续的呼吸困难症状一直是医护人员面临的挑战。本研究旨在评估与 COVID-19 幸存者,尤其是医护人员的生活质量和持续呼吸困难相关的因素。这项横断面研究在印度尼西亚棉兰市 H. Adam Malik 医院的医护人员中进行,采用直接访谈的方式收集数据。研究采用了欧洲质量标准五维五级量表(EQ-5D-5L)和自我评估型欧洲质量标准-视觉模拟量表(EQ-VAS)来评估医护人员的 QoL,并使用修改后的医学研究委员会(mMRC)量表来评估持续性呼吸困难。收集了可能的风险因素,如人口统计学特征、临床特征(合并症、住院史、氧气使用情况、COVID-19 疫苗接种史、既往 COVID-19 的严重程度、是否存在后 COVID 综合征)以及后 COVID 综合征的症状。采用卡方检验(Chi-squared test)或费雪精确检验(Fisher's exact test)来确定与 QoL 和持续性呼吸困难相关的风险因素。研究共纳入了 100 名医护人员,其中 2% 的医护人员感到疼痛/不适,4% 的医护人员感到焦虑/抑郁。医护人员的平均 EQ-VAS 得分为 87.6±8.1。所研究的人口统计学和临床特征与 QoL 各维度之间没有明显关联。然而,COVID 后的活动受限(p=0.004)、咽喉痛(p=0.026)、头痛(p=0.012)、肌痛(p=0.006)和关节痛(p=0.001)等症状与 QoL 的疼痛/不适维度相关。此外,活动受限(p=0.012)、头痛(p=0.020)、肌痛(p=0.015)和关节痛(p=0.032)与 QoL 的焦虑/抑郁维度也有显著关联。我们的数据表明,COVID 后综合征(p=0.006)、COVID 后综合征症状咳嗽(p=0.021)和疲劳(p=0.015)与持续性呼吸困难有关。总之,本研究表明,COVID 后综合征及其症状的存在与低健康相关生活质量和持续性呼吸困难有关。因此,需要对这类患者采取谨慎措施,以防止他们今后出现低质量生活水平。
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Factors associated with the quality of life and persistent dyspnea severity in COVID-19 survivors: A cross-sectional study among healthcare workers
The coronavirus disease 2019 (COVID-19) pandemic has a significant impact on global health. The alterations in quality of life (QoL) and the persistent symptom of dyspnea have been the healthcare workers’ challenges during and after the pandemic. The aim of this study was to assess factors associated with the QoL and persistent dyspnea experienced by COVID-19 survivors, particularly among healthcare workers. A cross-sectional study was conducted among healthcare workers at H. Adam Malik Hospital, Medan, Indonesia, using direct interviews to collect the data. The EuroQol 5-dimensional 5-level (EQ-5D-5L) and the self-assessment EuroQol-visual analog scale (EQ-VAS) were used to assess the QoL of the healthcare workers; and persistent dyspnea was evaluated using the modified Medical Research Council (mMRC) scale. Possible risk factors such as demographic characteristics, clinical characteristics (comorbidities, history of hospitalization, oxygen usage, history of COVID-19 vaccination, the severity of previous COVID-19, existence of post-COVID syndrome) and the symptoms of the post-COVID syndrome were collected. Chi-squared test or Fisher’s exact test were used to identify the risk factors associated with the QoL and persistent dyspnea. A total of 100 healthcare workers were included in the study and 2% of healthcare workers experienced pain/discomfortand 4% experienced anxiety/depression. The average healthcare worker’s EQ-VAS score was 87.6±8.1. There was no significant association between studied demographics and clinical characteristics with QoL dimensions. However, post-COVID symptoms of activity limitation (p=0.004), sore throat (p=0.026), headache (p=0.012), myalgia (p=0.006), and arthralgia (p=0.001) were associated with pain/discomfort dimension of QoL. In addition, there was a significant association between activity limitation (p=0.012), headache (p=0.020), myalgia (p=0.015) and arthralgia (p=0.032) with anxiety/depression dimension of QoL. Our data suggested that the presence of post-COVID syndrome (p=0.006) and the presence of post-COVID syndrome symptoms of cough (p=0.021) and fatigue (p=0.015) were associated with the persistent dyspnea. In conclusion, this study suggests that the presence of post-COVID syndrome and its symptoms are associated with low quality of health-related QoL and persistent dyspnea. Therefore, cautions are needed for such patients to prevent low QoL in the future.
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