Abstract
Background: Previous work has demonstrated that patients experience functional decline at 1-3 months post-discharge after COVID-19 hospitalization.
Objective: To determine whether symptoms persist further or improve over time, we followed patients discharged after hospitalization for severe COVID-19 to characterize their overall health status and their physical and mental health at 6 months post-hospital discharge.
Design: Prospective observational cohort study.
Participants: Patients ≥ 18 years hospitalized for COVID-19 at a single health system, who required at minimum 6 l of supplemental oxygen during admission, had intact baseline functional status, and were discharged alive.
Main measures: Overall health status, physical health, mental health, and dyspnea were assessed with validated surveys: the PROMIS® Global Health-10 and PROMIS® Dyspnea Characteristics instruments.
Key results: Of 152 patients who completed the 1 month post-discharge survey, 126 (83%) completed the 6-month survey. Median age of 6-month respondents was 62; 40% were female. Ninety-three (74%) patients reported that their health had not returned to baseline at 6 months, and endorsed a mean of 7.1 symptoms. Participants’ summary t-scores in both the physical health and mental health domains at 6 months (45.2, standard deviation [SD] 9.8; 47.4, SD 9.8, respectively) remained lower than their baseline (physical health 53.7, SD 9.4; mental health 54.2, SD 8.0; p<0.001). Overall, 79 (63%) patients reported shortness of breath within the prior week (median score 2 out of 10 (interquartile range [IQR] 0-5), vs 42 (33%) pre-COVID-19 infection (0, IQR 0-1)). A total of 11/124 (9%) patients without pre-COVID oxygen requirements still needed oxygen 6 months post-hospital discharge. One hundred and seven (85%) were still experiencing fatigue at 6 months post-discharge.
Conclusions: Even 6 months after hospital discharge, the majority of patients report that their health has not returned to normal. Support and treatments to return these patients back to their pre-COVID baseline are urgently needed.
Keywords: COVID-19; long-COVID; patient-reported outcomes; post-discharge outcomes.
【저자키워드】 COVID-19, long-COVID, Patient-reported outcomes, post-discharge outcomes., 【초록키워드】 Treatment, Hospitalized, severe COVID-19, Hospitalization, fatigue, mental health, Infection, oxygen, Symptom, Symptoms, discharge, outcomes, Health, Prospective, Dyspnea, female, Patient, COVID-19 hospitalization, age, Health status, health system, Admission, Shortness of breath, supplemental oxygen, Observational cohort study, interquartile range, Standard deviation, domain, hospital discharge, participant, Oxygen requirement, physical, Seven, IMPROVE, reported, remained, required, median, functional, majority, determine, demonstrated, discharged, returned, baseline, IQR, were assessed,