背景:从COVID-19康复的患者在日常活动中经常遇到与身体限制有关的持续问题,营养,认知,和心理功能。迄今为止,目前尚不清楚需要什么治疗来支持患者从COVID-19中恢复。
目的:本研究旨在评估6个月随访时COVID-19康复患者的初级专职医疗服务,并探讨哪些基线特征与基线和6个月随访之间的结局评分变化相关。
方法:这项荷兰全国性的前瞻性队列研究评估了接受初级专职医疗保健的患者的康复情况(即,营养师,运动治疗师,职业治疗师,物理治疗师,以及言语和语言治疗师)在COVID-19之后。初级专职医疗专业人员在日常实践中提供的所有治疗都是常规护理的一部分。患者报告的参与结局指标,与健康相关的生活质量,疲劳,身体机能,在基线和随访3个月和6个月时评估心理健康.线性混合模型分析用于评估随时间的回收率,使用单变量和多变量线性回归分析来检验基线特征与回收率之间的关联.
结果:共纳入了1451名从COVID-19康复并接受1名或更多初级专职医疗专业人员治疗的成年患者。对于参与(乌得勒支康复评估量表-参与范围0-100),所有时间点的估计平均差异至少为2.3点.对于健康相关的生活质量(EuroQol视觉模拟量表,范围0-100),6个月时的平均增加为12.3(95%CI11.1-13.6)点.发现疲劳有显著改善(疲劳严重程度量表,范围1-7):6个月时平均下降为-0.7(95%CI-0.8至-0.6)点。然而,742/929(79.9%)患者在6个月后报告出现严重疲劳.对于身体功能(患者报告结果测量信息系统-身体功能简表10b,范围13.8-61.3),6个月时平均增加5.9(95%CI5.9-6.4)点.6个月后发现焦虑(医院焦虑和抑郁量表范围为0-21)的-0.8(95%CI-1.0至-0.5)分和抑郁的-1.6(95%CI-1.8至-1.3)分的平均差异。更差的基线分数,入院,和男性与基线和6个月随访之间的更大改善相关,而年龄,BMI,合并症,吸烟状况与任何结局指标的平均变化均无相关性.
结论:接受初级专职医疗护理的COVID-19康复患者在康复方面取得了进展,但6个月后的日常活动仍然受到许多限制。我们的发现为医疗保健提供者和医疗保健政策制定者提供了参考价值,以了解从一名或多名初级专职医疗专业人员那里获得医疗保健的患者康复的期望。
背景:ClinicalTrials.govNCT04735744;https://tinyurl.com/3vf337pn.
■RR2-10.2340/jrm。v54.2506.
BACKGROUND: Patients recovering from COVID-19 often experience persistent problems in their daily activities related to limitations in physical, nutritional, cognitive, and mental functioning. To date, it is unknown what treatment is needed to support patients in their recovery from COVID-19.
OBJECTIVE: This study aimed to evaluate the primary allied health care of patients recovering from COVID-19 at 6-month follow-up and to explore which baseline characteristics are associated with changes in the scores of outcomes between baseline and 6-month follow-up.
METHODS: This Dutch nationwide prospective cohort study evaluated the recovery of patients receiving primary allied health care (ie, dietitians, exercise therapists, occupational therapists, physical therapists, and speech and language therapists) after COVID-19. All treatments offered by primary allied health professionals in daily practice were part of usual care. Patient-reported outcome measures on participation, health-related quality of life, fatigue, physical functioning, and psychological well-being were assessed at baseline and at 3- and 6-month follow-up. Linear mixed model analyses were used to evaluate recovery over time, and uni- and multivariable linear regression analyses were used to examine the association between baseline characteristics and recovery.
RESULTS: A total of 1451 adult patients recovering from COVID-19 and receiving treatment from 1 or more primary allied health professionals were included. For participation (Utrecht Scale for Evaluation of Rehabilitation-Participation range 0-100), estimated mean differences of at least 2.3 points were observed at all time points. For the health-related quality of life (EuroQol Visual Analog Scale, range 0-100), the mean increase was 12.3 (95% CI 11.1-13.6) points at 6 months. Significant improvements were found for fatigue (Fatigue Severity Scale, range 1-7): the mean decrease was -0.7 (95% CI -0.8 to -0.6) points at 6 months. However, severe fatigue was reported by 742/929 (79.9%) patients after 6 months. For physical functioning (Patient-Reported Outcomes Measurement Information System-Physical Function Short Form 10b, range 13.8-61.3), the mean increase was 5.9 (95% CI 5.9-6.4) points at 6 months. Mean differences of -0.8 (95% CI -1.0 to -0.5) points for anxiety (Hospital Anxiety and Depression Scale range 0-21) and -1.6 (95% CI -1.8 to -1.3) points for depression were found after 6 months. A worse baseline score, hospital admission, and male sex were associated with greater improvement between baseline and 6-month follow-up, whereas age, the BMI, comorbidities, and smoking status were not associated with mean changes in any outcome measures.
CONCLUSIONS: Patients recovering from COVID-19 who receive primary allied health care make progress in recovery but still experience many limitations in their daily activities after 6 months. Our findings provide reference values to health care providers and health care policy makers regarding what to expect from the recovery of patients who receive health care from 1 or more primary allied health professionals.
BACKGROUND: ClinicalTrials.gov NCT04735744; https://tinyurl.com/3vf337pn.
UNASSIGNED: RR2-10.2340/jrm.v54.2506.