Patient-reported health outcomes of SARS-CoV-2-tested patients presenting to emergency departments: a propensity score-matched prospective cohort study

R Bola; J Sutherland; R A Murphy; M Leeies; L Grant; J Hayward; P Archambault; L Graves; T Rose; C Hohl

doi:10.1016/j.puhe.2022.11.016

Patient-reported health outcomes of SARS-CoV-2-tested patients presenting to emergency departments: a propensity score-matched prospective cohort study

Public Health. 2023 Feb:215:1-11. doi: 10.1016/j.puhe.2022.11.016. Epub 2022 Dec 1.

Authors

R Bola¹, J Sutherland², R A Murphy³, M Leeies⁴, L Grant⁵, J Hayward⁶, P Archambault⁷, L Graves⁸, T Rose⁸, C Hohl⁹

Affiliations

¹ School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
² Centre for Health Services and Policy Research, University of British Columbia, Vancouver, BC, Canada.
³ School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada; Cancer Control Research, BC Cancer, Vancouver, BC, Canada.
⁴ Department of Emergency Medicine, University of Manitoba, Winnipeg, MB, Canada; Section of Critical Care Medicine, University of Manitoba, Winnipeg, MB, Canada.
⁵ Department of Emergency Medicine, McGill University, Montreal, QC, Canada; Emergency Department, Jewish General Hospital, Montreal, QC, Canada.
⁶ Department of Emergency Medicine, University of Alberta, AB, Canada.
⁷ Université Laval, Department of Family Medicine and Emergency Medicine, QC, Canada.
⁸ Patient Partner, Canadian COVID-19 Emergency Department Rapid Response Network Patient Engagement Committee, Canada.
⁹ Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada; Emergency Department, Vancouver General Hospital, Vancouver, BC, Canada. Electronic address: corinne.hohl@ubc.ca.

Abstract

Objective: This study aimed to compare the long-term physical and mental health outcomes of matched severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive and SARS-CoV-2-negative patients controlling for seasonal effects.

Study design: This was a retrospective cohort study.

Methods: This study enrolled patients presenting to emergency departments participating in the Canadian COVID-19 Emergency Department Rapid Response Network. We enrolled consecutive eligible consenting patients who presented between March 1, 2020, and July 14, 2021, and were tested for SARS-CoV-2. Research assistants randomly selected four site and date-matched SARS-CoV-2-negative controls for every SARS-CoV-2-positive patient and interviewed them at least 30 days after discharge. We used propensity scores to match patients by baseline characteristics and used linear regression to compare Veterans RAND 12-item physical health component score (PCS) and mental health component scores (MCS), with higher scores indicating better self-reported health.

Results: We included 1170 SARS-CoV-2-positive patients and 3716 test-negative controls. The adjusted mean difference for PCS was 0.50 (95% confidence interval [CI]: -0.36, 1.36) and -1.01 (95% CI: -1.91, -0.11) for MCS. Severe disease was strongly associated with worse PCS (β = -7.4; 95% CI: -9.8, -5.1), whereas prior mental health illness was strongly associated with worse MCS (β = -5.4; 95% CI: -6.3, -4.5).

Conclusion: Physical health, assessed by PCS, was similar between matched SARS-CoV-2-positive and SARS-CoV-2-negative patients, whereas mental health, assessed by MCS, was worse during a time when the public experienced barriers to care. These results may inform the development and prioritization of support programs for patients.

Keywords: CCEDRRN; COVID-19; Emergency departments; Patient-reported outcomes; Propensity scores.

MeSH terms

COVID-19*
Canada
Humans
Outcome Assessment, Health Care
Propensity Score
Prospective Studies
Retrospective Studies
SARS-CoV-2*