Predictors of Long-COVID-19 and its Impact on Quality of Life: Longitudinal Analysis at 3, 6 and 9 Months after Discharge from a Portuguese Centre
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19047 |
Resumo: | Introduction: Long-COVID-19 impacts health-related quality of life (HR-QoL) but data is scarce. The aim of this study was to describe and prospectively assess the prevalence and risk factors for long-COVID-19 after hospital discharge, and to evaluate its impact on patient HR-QoL.Methods: Single-centre longitudinal study including all COVID-19 patients discharged between December 2020 and February 2021. Patients were contacted remotely at three, six and nine months. Data were collected as follows: 1) Long-COVID-19 symptoms were self-reported; 2) HRQoL were assessed using the 3-level EuroQoL-5D (EQ-5D-3L) questionnaire. Pregnant women, demented, bedridden, and non-Portuguese-speaking patients were excluded.Results: The three-, six- and nine-month assessments were completed by 152, 117 and 110 patients (median age: 61 years; male sex: 56.6%). Long-COVID-19 (≥ 1 symptom) was reported by 66.5%, 62.4% and 53.6% of patients and HR-QoL assessment showed impairment of at least some domain in 65.8%, 69.2% and 55.4% of patients at three, six and nine months, respectively. Fatigue was the most common long-COVID-19 symptom. Anxiety/depression domain was the most frequently affected in all three time-points, peaking at six months (39%), followed by pain/discomfort and mobility domains. Long-COVID-19 was associated with the impairment of all EQ-5D-3L domains except for self-care domain at each time-point. Neither intensive care unit admission nor disease severity were associated with long-COVID-19 nor with impairment of any EQ-5D-3L domain. After adjusting for sex, age, frailty status, and comorbid conditions, long-COVID-19 remained significantly associated with HR-QoL impairment at three (OR 4.27, 95% CI 1.92 – 9.52, p < 0.001), six (OR 3.46, 95% CI 1.40 – 8.57, p = 0.007) and nine months (OR 4.13, 95% CI 1.62 – 10.55, p = 0.003) after hospital discharge. In alongitudinal analysis, patients reporting long-COVID-19 at three months had an EQ-5D-3L index value decreased by 0.14 per visit (p < 0.001) compared to those without long-COVID-19 and both groups had a non-significant change in mean EQ-5D-3L index over the nine-month period (time-point assessment, Z = 0.91, p = 0.364).Conclusion: Clinical sequelae associated with long-COVID-19 can persist for at least nine months after hospital discharge in most patients and can impair long-term HR-QoL in more than half of patients regardless of disease severity, and clinicodemographic characteristics. |
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Predictors of Long-COVID-19 and its Impact on Quality of Life: Longitudinal Analysis at 3, 6 and 9 Months after Discharge from a Portuguese CentrePreditores da COVID-19 Longa e o seu Impacto na Qualidade de Vida: Análise Longitudinal aos 3, 6 e 9 Meses após a Alta de um Centro PortuguêsCOVID-19PortugalPost-Acute COVID-19 SyndromeQuality of LifeCOVID-19PortugalQualidade de VidaSíndrome Pós-COVID-19Introduction: Long-COVID-19 impacts health-related quality of life (HR-QoL) but data is scarce. The aim of this study was to describe and prospectively assess the prevalence and risk factors for long-COVID-19 after hospital discharge, and to evaluate its impact on patient HR-QoL.Methods: Single-centre longitudinal study including all COVID-19 patients discharged between December 2020 and February 2021. Patients were contacted remotely at three, six and nine months. Data were collected as follows: 1) Long-COVID-19 symptoms were self-reported; 2) HRQoL were assessed using the 3-level EuroQoL-5D (EQ-5D-3L) questionnaire. Pregnant women, demented, bedridden, and non-Portuguese-speaking patients were excluded.Results: The three-, six- and nine-month assessments were completed by 152, 117 and 110 patients (median age: 61 years; male sex: 56.6%). Long-COVID-19 (≥ 1 symptom) was reported by 66.5%, 62.4% and 53.6% of patients and HR-QoL assessment showed impairment of at least some domain in 65.8%, 69.2% and 55.4% of patients at three, six and nine months, respectively. Fatigue was the most common long-COVID-19 symptom. Anxiety/depression domain was the most frequently affected in all three time-points, peaking at six months (39%), followed by pain/discomfort and mobility domains. Long-COVID-19 was associated with the impairment of all EQ-5D-3L domains except for self-care domain at each time-point. Neither intensive care unit admission nor disease severity were associated with long-COVID-19 nor with impairment of any EQ-5D-3L domain. After adjusting for sex, age, frailty status, and comorbid conditions, long-COVID-19 remained significantly associated with HR-QoL impairment at three (OR 4.27, 95% CI 1.92 – 9.52, p < 0.001), six (OR 3.46, 95% CI 1.40 – 8.57, p = 0.007) and nine months (OR 4.13, 95% CI 1.62 – 10.55, p = 0.003) after hospital discharge. In alongitudinal analysis, patients reporting long-COVID-19 at three months had an EQ-5D-3L index value decreased by 0.14 per visit (p < 0.001) compared to those without long-COVID-19 and both groups had a non-significant change in mean EQ-5D-3L index over the nine-month period (time-point assessment, Z = 0.91, p = 0.364).Conclusion: Clinical sequelae associated with long-COVID-19 can persist for at least nine months after hospital discharge in most patients and can impair long-term HR-QoL in more than half of patients regardless of disease severity, and clinicodemographic characteristics.Introdução: Os dados referentes ao efeito da COVID-19 longa na qualidade de vida relacionada com a saúde (QV-RS) são escassos. O objetivo deste estudo foi descrever prospectivamente a prevalência e os fatores de risco associados à COVID-19 longa após a alta hospitalar e avaliar o seu impacto na QV-RS.Métodos: Estudo longitudinal unicêntrico incluindo todos os doentes com COVID-19 com alta hospitalar entre dezembro de 2020 e fevereiro de 2021. Os doentes foram contactados telefonicamente aos três, seis e nove meses. Os dados foram colhidos da seguinte forma: 1) autorrelato dos sintomas associados à COVID-19 longa; 2) avaliação da QV-RS através do questionário de três níveis EuroQoL-5D (EQ-5D-3L). Excluímos grávidas, doentes dementes, acamados e não-falantes de português.Resultados: Cento e cinquenta e dois, 117 e 110 doentes foram avaliados aos três, seis e nove meses (idade mediana: 61 anos; homens: 56,6%). A COVID-19 longa (≥ 1 sintoma) estava presente em 66,5%, 62,4% e 53,6% dos doentes, e 65,8%, 69,2% e 55,4% descreveram compromisso da QV-RS (≥ 1 domínio) aos três, seis e nove meses, respetivamente. O sintoma persistente mais comum foi a fadiga. O domínio ansiedade/depressão foi o mais afetado nos três momentos, com pico aos seis meses (39%), seguido pelos domínios dor/desconforto e mobilidade. A COVID-19 longa associou-se ao compromisso de todos os domínios da EQ-5D-3L, exceto ao do autocuidado. Nem a admissão nos cuidados intensivos nem a gravidade da doença se associou à COVID-19 longa nem ao compromisso de qualquer domínio da EQ-5D-3L. A COVID-19 longa permaneceu significativamente associado à diminuição da QV-RS aos três (OR 4,27, IC 95% 1,92 – 9,52, p < 0,001), seis (OR 3,46, IC 95% 1,40 – 8,57, p = 0,007) e nove meses (OR 4,13, IC 95% 1,62 – 10,55, p = 0,003) após ajuste para o sexo, idade, grau de autonomia e comorbilidades. Na análise longitudinal, o índice EQ-5D-3L estava diminuído em 0,14/visita (p < 0,001) nos doentes com COVID-19 longa aos três meses em comparação com os assintomáticos, e ambos os grupos mostraram uma variação não significativa do índice EQ-5D-3L durante os nove meses do estudo (Z = 0,91, p = 0,364).Conclusão: As sequelas clínicas associadas à COVID-19 longa podem persistir por pelo menos nove meses após a alta hospitalar e podem comprometer a QV-RS a longo prazo em mais da metade dos doentes, independentemente da gravidade da doença e das características clinicodemográficas.Ordem dos Médicos2023-02-24info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfapplication/pdfapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19047Acta Médica Portuguesa; Vol. 36 No. 10 (2023): October; 647-660Acta Médica Portuguesa; Vol. 36 N.º 10 (2023): Outubro; 647-6601646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19047https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19047/15049https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19047/15050https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19047/15051https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19047/15052Direitos de Autor (c) 2023 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessGaspar, PedroDias, MarianaParreira, InêsGonçalves, Hélder DiogoParlato, FedericaMaione, ValeriaAtalaia Barbacena, HenriqueCarreiro, CarolinaDuarte, Leila2024-01-28T03:00:21Zoai:ojs.www.actamedicaportuguesa.com:article/19047Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:47:19.527132Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Predictors of Long-COVID-19 and its Impact on Quality of Life: Longitudinal Analysis at 3, 6 and 9 Months after Discharge from a Portuguese Centre Preditores da COVID-19 Longa e o seu Impacto na Qualidade de Vida: Análise Longitudinal aos 3, 6 e 9 Meses após a Alta de um Centro Português |
title |
Predictors of Long-COVID-19 and its Impact on Quality of Life: Longitudinal Analysis at 3, 6 and 9 Months after Discharge from a Portuguese Centre |
spellingShingle |
Predictors of Long-COVID-19 and its Impact on Quality of Life: Longitudinal Analysis at 3, 6 and 9 Months after Discharge from a Portuguese Centre Gaspar, Pedro COVID-19 Portugal Post-Acute COVID-19 Syndrome Quality of Life COVID-19 Portugal Qualidade de Vida Síndrome Pós-COVID-19 |
title_short |
Predictors of Long-COVID-19 and its Impact on Quality of Life: Longitudinal Analysis at 3, 6 and 9 Months after Discharge from a Portuguese Centre |
title_full |
Predictors of Long-COVID-19 and its Impact on Quality of Life: Longitudinal Analysis at 3, 6 and 9 Months after Discharge from a Portuguese Centre |
title_fullStr |
Predictors of Long-COVID-19 and its Impact on Quality of Life: Longitudinal Analysis at 3, 6 and 9 Months after Discharge from a Portuguese Centre |
title_full_unstemmed |
Predictors of Long-COVID-19 and its Impact on Quality of Life: Longitudinal Analysis at 3, 6 and 9 Months after Discharge from a Portuguese Centre |
title_sort |
Predictors of Long-COVID-19 and its Impact on Quality of Life: Longitudinal Analysis at 3, 6 and 9 Months after Discharge from a Portuguese Centre |
author |
Gaspar, Pedro |
author_facet |
Gaspar, Pedro Dias, Mariana Parreira, Inês Gonçalves, Hélder Diogo Parlato, Federica Maione, Valeria Atalaia Barbacena, Henrique Carreiro, Carolina Duarte, Leila |
author_role |
author |
author2 |
Dias, Mariana Parreira, Inês Gonçalves, Hélder Diogo Parlato, Federica Maione, Valeria Atalaia Barbacena, Henrique Carreiro, Carolina Duarte, Leila |
author2_role |
author author author author author author author author |
dc.contributor.author.fl_str_mv |
Gaspar, Pedro Dias, Mariana Parreira, Inês Gonçalves, Hélder Diogo Parlato, Federica Maione, Valeria Atalaia Barbacena, Henrique Carreiro, Carolina Duarte, Leila |
dc.subject.por.fl_str_mv |
COVID-19 Portugal Post-Acute COVID-19 Syndrome Quality of Life COVID-19 Portugal Qualidade de Vida Síndrome Pós-COVID-19 |
topic |
COVID-19 Portugal Post-Acute COVID-19 Syndrome Quality of Life COVID-19 Portugal Qualidade de Vida Síndrome Pós-COVID-19 |
description |
Introduction: Long-COVID-19 impacts health-related quality of life (HR-QoL) but data is scarce. The aim of this study was to describe and prospectively assess the prevalence and risk factors for long-COVID-19 after hospital discharge, and to evaluate its impact on patient HR-QoL.Methods: Single-centre longitudinal study including all COVID-19 patients discharged between December 2020 and February 2021. Patients were contacted remotely at three, six and nine months. Data were collected as follows: 1) Long-COVID-19 symptoms were self-reported; 2) HRQoL were assessed using the 3-level EuroQoL-5D (EQ-5D-3L) questionnaire. Pregnant women, demented, bedridden, and non-Portuguese-speaking patients were excluded.Results: The three-, six- and nine-month assessments were completed by 152, 117 and 110 patients (median age: 61 years; male sex: 56.6%). Long-COVID-19 (≥ 1 symptom) was reported by 66.5%, 62.4% and 53.6% of patients and HR-QoL assessment showed impairment of at least some domain in 65.8%, 69.2% and 55.4% of patients at three, six and nine months, respectively. Fatigue was the most common long-COVID-19 symptom. Anxiety/depression domain was the most frequently affected in all three time-points, peaking at six months (39%), followed by pain/discomfort and mobility domains. Long-COVID-19 was associated with the impairment of all EQ-5D-3L domains except for self-care domain at each time-point. Neither intensive care unit admission nor disease severity were associated with long-COVID-19 nor with impairment of any EQ-5D-3L domain. After adjusting for sex, age, frailty status, and comorbid conditions, long-COVID-19 remained significantly associated with HR-QoL impairment at three (OR 4.27, 95% CI 1.92 – 9.52, p < 0.001), six (OR 3.46, 95% CI 1.40 – 8.57, p = 0.007) and nine months (OR 4.13, 95% CI 1.62 – 10.55, p = 0.003) after hospital discharge. In alongitudinal analysis, patients reporting long-COVID-19 at three months had an EQ-5D-3L index value decreased by 0.14 per visit (p < 0.001) compared to those without long-COVID-19 and both groups had a non-significant change in mean EQ-5D-3L index over the nine-month period (time-point assessment, Z = 0.91, p = 0.364).Conclusion: Clinical sequelae associated with long-COVID-19 can persist for at least nine months after hospital discharge in most patients and can impair long-term HR-QoL in more than half of patients regardless of disease severity, and clinicodemographic characteristics. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-02-24 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19047 |
url |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19047 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19047 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19047/15049 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19047/15050 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19047/15051 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19047/15052 |
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Direitos de Autor (c) 2023 Acta Médica Portuguesa info:eu-repo/semantics/openAccess |
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Direitos de Autor (c) 2023 Acta Médica Portuguesa |
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openAccess |
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application/pdf application/pdf application/pdf application/pdf |
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Ordem dos Médicos |
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Ordem dos Médicos |
dc.source.none.fl_str_mv |
Acta Médica Portuguesa; Vol. 36 No. 10 (2023): October; 647-660 Acta Médica Portuguesa; Vol. 36 N.º 10 (2023): Outubro; 647-660 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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