Clinical outcomes and quality of life of COVID-19 survivors: A follow-up of 3 months post hospital discharge

Respir Med. 2021 Aug:184:106453. doi: 10.1016/j.rmed.2021.106453. Epub 2021 May 13.

Abstract

Background: Over 66 million people worldwide have been diagnosed with COVID-19. Therefore, understanding their clinical evolution beyond hospital discharge is essential not only from an individual standpoint, but from a populational level.

Objectives: Our primary aim was to assess the impact of COVID-19 on health-related quality of life (HRQoL) 3 months after hospital discharge. Additionally, we screened for anxiety and depression and assessed important clinical outcomes.

Methods: This was a single-center cohort study performed in Sao Paulo (Brazil), in which participants were contacted by telephone to answer a short survey. EQ-5D-3L was used to assess HRQoL and clinical data from patients' index admission were retrieved from medical records.

Results: We contacted 251 participants (59.8% males, mean age 53 years old), 69.7% of which had presented with severe COVID-19. At 3 months of follow-up, 6 patients had died, 51 (20.3%) had visited the emergency department again and 17 (6.8%) had been readmitted to hospital. Seventy patients (27.9%) persisted with increased dyspnoea and 81 had a positive screening for anxiety/depression. Similarly, patients reported an overall worsening of EQ-5D-3L single summary index at 3 months compared to before the onset of COVID-19 symptoms (0.8012 (0.7368 - 1.0) vs. 1.0(0.7368 - 1.0), p < 0.001). This affected all 5 domains, but especially pain/discomfort and anxiety/depression. Only female sex and intensive care requirement were independently associated with worsening of HRQoL.

Conclusion: Patients hospitalized for COVID-19 frequently face persistent clinical and mental health problems up to 3 months following hospital discharge, with significant impact on patients' HRQoL.

Keywords: COVID-19; Critical care; Quality of life.

MeSH terms

  • Anxiety
  • Brazil
  • COVID-19 / psychology*
  • Cohort Studies
  • Critical Care Outcomes*
  • Depression
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Mental Health*
  • Middle Aged
  • Patient Discharge*
  • Quality of Life*
  • Sex Factors
  • Surveys and Questionnaires
  • Survivors*
  • Time Factors