Journal of Hospital Medicine ( IF 2.4 ) Pub Date : 2021-08-18 , DOI: 10.12788/jhm.3660 Theodore J Iwashyna 1, 2 , Lee A Kamphuis 2 , Stephanie J Gundel 3 , Aluko A Hope 4, 5 , Sarah Jolley 6 , Andrew J Admon 1 , Ellen Caldwell 7 , Max L Monahan 2 , Katherine Hauschildt 2 , B Taylor Thompson 8 , Catherine L Hough 5 ,
BACKGROUND: Patients discharged after COVID-19 report ongoing needs.
OBJECTIVES: To measure incident symptoms after COVID-19 hospitalization.
DESIGN, SETTING, AND PARTICIPANTS: Preplanned early look at 1-month follow-up surveys from patients hospitalized August 2020 to January 2021 in NHLBI PETAL Network’s Biology and Longitudinal Epidemiology: COVID-19 Observational (BLUE CORAL) study. English- or Spanish-speaking hospitalized adults without substantial pre-COVID-19 disability with a positive molecular test for SARS-CoV-2.
RESULTS: Overall, 253 patients were hospitalized for a median of 5 days (interquartile range [IQR], 3-8), and had a median age of 60 years (IQR, 45-68). By race/ethnicity, 136 (53.8%) were non-Hispanic White, 23 (9.1%) were non-Hispanic Black, and 83 (32.8%) were Hispanic. Most (139 [54.9%]) reported a new or worsened cardiopulmonary symptom, and 16% (n = 39) reported new or increased oxygen use; 213 (84.2%) patients reported not feeling fully back to their pre-COVID-19 level of functioning. New limitations in activities of daily living were present in 130 (52.8%) patients. Financial toxicities, including job loss or change (49 [19.8%]), having a loved one take time off (93 [37.8%]), and using up one’s savings (58 [23.2%]), were common. Longer lengths of hospital stay were associated with greater odds of 1-month cardiopulmonary symptoms (adjusted odds ratio [aOR], 1.82 per additional week in the hospital; 95% CI, 1.11-2.98) and new disability (aOR, 2.06; 95% CI, 1.21-3.53). There were not uniform demographic patterns of association.
LIMITATIONS: We prioritized patients’ reports of their own incident problems over objective testing.
CONCLUSION: Patients who survived COVID-19 in the United States during late 2020/early 2021 still faced new burdens 1 month after hospital discharge.
中文翻译:
第三波 COVID-19 住院 1 个月后持续心肺症状、残疾和经济毒性:美国全国队列的早期结果
背景: COVID-19 后出院的患者报告了持续的需求。
目的:测量 COVID-19 住院后的事件症状。
设计、设置和参与者:在 NHLBI PETAL Network 的生物学和纵向流行病学:COVID-19 观察性 (BLUE CORAL) 研究中,预先计划对 2020 年 8 月至 2021 年 1 月住院患者进行的 1 个月随访调查。讲英语或西班牙语的住院成人,在 COVID-19 之前没有严重残疾,且 SARS-CoV-2 分子检测呈阳性。
结果:总体而言,253 名患者住院时间中位数为 5 天(四分位距 [IQR],3-8),中位年龄为 60 岁(IQR,45-68)。按种族/民族划分,136 人(53.8%)为非西班牙裔白人,23 人(9.1%)为非西班牙裔黑人,83 人(32.8%)为西班牙裔。大多数人 (139 [54.9%]) 报告出现新的或恶化的心肺症状,16% (n = 39) 报告出现新的或氧气使用量增加; 213 名 (84.2%) 患者表示感觉没有完全恢复到 COVID-19 之前的功能水平。 130 名 (52.8%) 患者的日常生活活动出现新的限制。财务毒性很常见,包括失业或变动(49 [19.8%])、亲人请假(93 [37.8%])以及耗尽积蓄(58 [23.2%])。住院时间越长,出现 1 个月心肺症状的几率越大(调整后比值比 [aOR],住院每增加一周 1.82;95% CI,1.11-2.98)和新残疾(aOR,2.06;95%) CI,1.21-3.53)。没有统一的人口统计模式。
局限性:我们优先考虑患者对自己事件问题的报告,而不是客观测试。
结论: 2020 年底/2021 年初美国的 COVID-19 幸存者在出院 1 个月后仍面临新的负担。