COVID-19 存活者的长期健康相关生活质量和身体功能(ICU 引起的虚弱

Tomoyo Taketa, Y. Uchiyama, Yohei Miyagi, Seiya Yamakawa, Tetsu Seo, Ai Yanagida, N. Sasanuma, N. Kodama, K. Domen
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摘要

摘要 目的:本研究调查了被诊断为重症监护室获得性肌无力(ICU-AW)的冠状病毒 2019(COVID-19)幸存者的长期健康相关生活质量(HRQOL)和身体功能。评估ICU出院时肌无力与HRQOL之间的相关性。研究方法对2021年1月至2021年11月期间入住兵库医科大学医院重症监护室的COVID-19患者进行了一项回顾性研究。使用 SF-36 问卷对患者的 HRQOL 进行评估,并在患者发病 18 个月后对其身体功能进行评估,包括通过医学研究委员会总分(MRC-SS)评估的肌肉力量、握力和 6 分钟步行距离(6MWD)。在 ICU 出院时,MRC-SS 小于 48 分的患者被诊断为 ICU-AW。我们研究了 ICU 出院时的 MRC-SS 与长期临床结果之间的相关性。研究结果我们共纳入了 26 例患者,其中 13 例患有 ICU-AW。在长期随访中,ICU-AW 组的 SF-36 分量表(如身体功能 (PF)、角色限制-身体 (RP)、身体疼痛 (BP)、活力 (VT)、社会功能 (SF) 和角色限制-情感 (RE))以及身体成分总分 (PCS) 均明显低于无 ICU-AW 组。ICU-AW 组的肌肉力量也有所下降。在 18 个月的随访中,ICU 出院时的 MRC-SS 与 SF-36 中的 PF、RP、BP、SF、RE 和 PCS 呈正相关。结论患有 ICU-AW 的 COVID-19 幸存者的长期 HRQOL 有所下降,ICU 出院时的肌无力与长期 HRQOL 相关。
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Long-term Health-related Quality of Life and Physical Function of COVID-19 Survivors with ICU-acquired Weakness
ABSTRACT Objectives: This study examined the long-term health-related quality of life (HRQOL) and physical function of coronavirus 2019 (COVID-19) survivors diagnosed with intensive care unit-acquired weakness (ICU-AW). The correlation between muscle weakness at ICU discharge and HRQOL was assessed. Methods: A retrospective study was conducted on COVID-19 patients admitted to the ICU at Hyogo Medical University Hospital between January 2021 and November 2021. The HRQOL was evaluated using the SF-36 questionnaire, and physical function, including muscle strength assessed by the Medical Research Council Sum Score (MRC-SS), grip strength, and the 6-min walk distance (6MWD), were assessed 18 months after the onset. ICU-AW was diagnosed in patients with an MRC-SS of less than 48 at ICU discharge. We investigated the correlations between the MRC-SS at ICU discharge and the long-term clinical outcomes. Results: We included 26 patients, with 13 having ICU-AW. In the long-term follow-up, the ICU-AW group had significantly lower scores than the no ICU-AW group in the SF-36 subscales such as Physical Functioning (PF), Role Limitation-Physical (RP), Bodily Pain (BP), Vitality (VT), Social Functioning (SF), and Role Limitation-Emotional (RE), as well as in the Physical Component Summary Score (PCS). The muscle strength was also decreased in the ICU-AW group. The MRC-SS at ICU discharge was positively correlated with PF, RP, BP, SF, RE, and PCS in SF-36 at the 18-month follow-up. Conclusions: COVID-19 survivors with ICU-AW experienced a long-term decline in HRQOL, and muscle weakness at ICU discharge was correlated with the long-term HRQOL.
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