Respiratory medicine · 2025
Health-related quality of life after 12 Months of discharge from specialized weaning centers for post-COVID-19 patients: A multicenter cohort study.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Navarro Emiliano, Villalba Darío, Matesa Amelia, De Paoli Silvana, Cotero Alejo, Nadur Juan, Delvalle Mirian L, Musso Gabriel, Leingruber Mariel, Prieto Luciana, Bosso Mauro J, Segura Analía, Vallory María E, Campodónico Romina, Duarte Carlos, Larocca Florencia, Brusco Andrés, Morales Virginia, Pieruzzi Selva Del C, De Vito Eduardo Luis
Аннотация
BACKGROUND: The COVID-19 pandemic led to increased intensive care (ICU) admissions and prolonged mechanical ventilation (MV), leaving many patients with persistent physical, cognitive, and respiratory impairments. Tracheostomized, MV-dependent post-COVID-19 patients in Specialized Weaning Centers (SWCs) often experience significantly reduced health-related quality of life (HRQoL) after discharge. Despite this burden, HRQoL data-especially from resource-limited settings-remain scarce.
OBJECTIVES: To evaluate HRQoL 12 months post-discharge in tracheostomized post-COVID-19 survivors from SWCs, compare results with reference values, and identify factors associated with HRQoL decline.
METHODS: This prospective multicenter cohort study was conducted in Argentina. Tracheostomized post-COVID-19 survivors discharged home from SWCs between July 2020 and December 2021 were interviewed by telephone 12 months post-discharge. Data collected included clinical characteristics, HRQoL (EQ-5D-5L), healthcare utilization, and employment status.
RESULTS: A total of 203 patients (mean age 58 years) were enrolled. The EQ-5D-5L indicated substantial impairments, with 64.5 % reporting difficulties in at least one dimension. Compared to the reference population, patients had significantly lower scores in mobility, self-care, and usual activities (p < 0.001), and a lower EQ-5D-5L index (0.916 vs. 0.954; p = 0.001). Female sex and prolonged rehabilitation stays were associated with worse outcomes. Multivariable analysis showed prolonged SWC stay was independently associated with lower HRQoL (p = 0.035). Additionally, 17 % were unemployed and 9.3 % required personal care.
CONCLUSION: One year post-discharge, tracheostomized post-COVID-19 patients experience significant HRQoL impairments. These findings highlight the urgent need for targeted rehabilitation strategies and support systems, particularly in resource-limited settings.
OBJECTIVES: To evaluate HRQoL 12 months post-discharge in tracheostomized post-COVID-19 survivors from SWCs, compare results with reference values, and identify factors associated with HRQoL decline.
METHODS: This prospective multicenter cohort study was conducted in Argentina. Tracheostomized post-COVID-19 survivors discharged home from SWCs between July 2020 and December 2021 were interviewed by telephone 12 months post-discharge. Data collected included clinical characteristics, HRQoL (EQ-5D-5L), healthcare utilization, and employment status.
RESULTS: A total of 203 patients (mean age 58 years) were enrolled. The EQ-5D-5L indicated substantial impairments, with 64.5 % reporting difficulties in at least one dimension. Compared to the reference population, patients had significantly lower scores in mobility, self-care, and usual activities (p < 0.001), and a lower EQ-5D-5L index (0.916 vs. 0.954; p = 0.001). Female sex and prolonged rehabilitation stays were associated with worse outcomes. Multivariable analysis showed prolonged SWC stay was independently associated with lower HRQoL (p = 0.035). Additionally, 17 % were unemployed and 9.3 % required personal care.
CONCLUSION: One year post-discharge, tracheostomized post-COVID-19 patients experience significant HRQoL impairments. These findings highlight the urgent need for targeted rehabilitation strategies and support systems, particularly in resource-limited settings.