严重患病的COVID-19幸存者的长期康复:一项前性队列研究
Ingrid Didriksson1,2, Attila Frigyesi1,3, Martin Spångfors1,4
1Department of Clinical Sciences, Anaesthesiology and Intensive Care, Lund University, Lund, Sweden.
Acta anaesthesiologica Scandinavica
|November 14, 2024
概括
重症COVID-19幸存者在重症监护室出院一年后,在功能结果和与身体健康相关的生活质量 (HRQoL) 中显著改善. 较短的机械通风持续时间与更好的恢复相关,而较长的年龄与更好的功能结果有关.
科学领域:
- 关键护理医学 关键护理医学
- 传染病 传染病 传染病
- 康复医学是康复的医学.
背景情况:
- 重症COVID-19患者的长期康复轨迹仍未得到充分调查.
- 了解重症监护室 (ICU) 后结果对于患者管理至关重要.
研究的目的:
- 评估重症COVID-19幸存者在ICU后3至12个月的功能状态和健康相关生活质量 (HRQoL) 的变化.
- 确定预测12个月后有利的功能和HRQoL结果的因素.
主要方法:
- 一项前性,多中心队列研究,涉及瑞典ICU的重症COVID-19患者 (2020年5月至2021年5月).
- 在3个月和12个月的后续评估中,使用格拉斯哥结果量表扩展 (GOSE) 进行功能和SF-36v2® HRQoL (PCS和MCS分数).
- 多变量逻辑回归分析了12个月后GOSE (≥7) 和HRQoL (PCS/MCS ≥45) 的预测指标.
主要成果:
- 良好的功能结果 (GOSE) 从3个月的35%显著改善到12个月的64% (p < .001).
- 平均物理组件总结 (PCS) 评分有所改善 (40至44,p<.001),而心理组件总结 (MCS) 评分保持稳定,在正常范围内 (46至48,p=.05).
- 较短的机械通风持续时间与所有措施中的更好的结果有关. 高龄预测了更好的功能结果,而较低的脆弱性和缺乏糖尿病预测了更好的PCS.
结论:
- 患重病的COVID-19幸存者在ICU后3至12个月之间表现出功能状态和身体HRQoL的实质性恢复.
- 较短的机械通风是有利的功能和HRQoL结果的关键因素.
- 有针对性的后续和康复策略可能有利于年轻患者,并发病症患者或较高脆弱程度的患者.
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