scholarly journals Short-term health-related quality of life, physical function and psychological consequences of severe COVID-19

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Luca Carenzo ◽  
Alessandro Protti ◽  
Francesca Dalla Corte ◽  
Romina Aceto ◽  
Giacomo Iapichino ◽  
...  

Abstract Background Survivors of severe COVID-19 are at risk of impaired health-related quality of life (HRQoL) and persistent physical and psychological disability after ICU and hospital discharge. The subsequent social burden is a major concern. We aimed to assess the short-term HRQoL, physical function and prevalence of post-traumatic stress symptoms of invasively mechanically ventilated COVID-19 patients treated in our ICU. Methods Prospective, observational cohort study in a follow-up clinic. Patients completed a 6-min walking test (6MWT) to assess their cardio-pulmonary function around 2 months (early follow-up) from hospital discharge, the EQ-5D-5L questionnaire for quality of life assessment around 2 months and at 6 months from hospital discharge and an anonymous web-based Impact of Event Scale-Revised (IES-R) questionnaire for Post-Traumatic Stress symptoms at 2 months. Results 47 patients attended our follow-up program, mean age 59 ± 10 years, median pre-morbid Clinical Frailty Scale (CFS) 2 [2–3]. The median distance walked in 6 min was 470 [406–516] m, 83 [67–99]% of the predicted value. Overall 1 out 3 patients and 4/18 (22%) among those with a good functional baseline prior to COVID-19 (CFS of 1 or 2) had lower (84%) than predicted 6MWT. EQ-5D-5L quality of life VAS was 80 [70–90] out of 100 at early follow-up with a slight improvement to 85 [77.5–90] at 6 months. Mobility, self-care and usual activities improved between the two timepoints, while pain/discomfort and depression/anxiety did not improve or got worse. The IES-R total score was greater than the threshold for concern of 1.6 in 27/41(66%) respondents. Conclusions Patients recovering from severe COVID-19 requiring invasive mechanical ventilation surviving hospital discharge present with early mild to moderate functional impairment, mildly reduced quality of life from hospital discharge with an overall improvement of mobility, self-care and the ability of performing usual activities, while a worsening of pain and depression/anxiety symptoms at 6 months and a large proportion of symptoms of post-traumatic distress soon after hospital discharge.

2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
G Christopoulou ◽  
E Sigala ◽  
D Aragiannis ◽  
E Stamatopoulou ◽  
P Manthou ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: None. Introduction/Purpose: Patent foramen ovale (PFO) is common in asymptomatic adults and is associated with cryptogenic stroke (CS). We sought to evaluate the impact of PFO closure in health-related quality of life (HRQoL) in PFO patients with CS.  Method In this pilot study, 19 patients (mean age 47 ± 7.7; 13 male) who underwent PFO closure at our center were invited to a short-term clinical follow up (mean follow-up period 6-10 months). All patients had suffered an ischaemic stroke and their disability level was assessed using the Modified Rankin Scale (MRS, no significant disability 63%). HRQoL was assessed using the 36-Item Short Form Survey (SF-36) and the European Quality of Life-5 Dimensions Questionnaire (EQ-5D) preoperatively and at follow-up.  Results Both SF36 and EQ-5D scores improved after the operation as shown by the self-rating scores (20,67% and 40,52% higher scores, respectively). Patients with major mobility problems were more likely to be current smokers (r = 0.481) and those who had lower scores on the MRS scale (r=-0.571) rated higher their scale diagram.  The categories of energy/fatigue (r = 0.459; p = 0.048), social functioning (r = 0.547; p = 0.015) and pain (r = 0.550; p = 0.015) were positively correlated with physical function. Finally, there was a positive correlation between role limitations due to emotional problems and energy/fatigue (r = 0,519; p = 0.023), and between energy/fatigue and emotional well-being (r = 0.519; p = 0,023). Conclusions The results of our study indicate that shortly after PFO, subjects perceive improvements in their QoL. However, it seems that poorly rated physical function was more common in active smokers, and affects patients" social life and their emotional state. Health care professionals should encourage these patients to participate in rehabilitation and psychological support programs postoperatively.


2019 ◽  
Vol 27 (2) ◽  
Author(s):  
Janelle Monique Morhun ◽  
N.M. Racine ◽  
G.M.T. Guilcher ◽  
L.M. Tomfohr-Madsen ◽  
F.S.M. Schulte

Background: The unique psychosocial needs of parents and caregivers of young children with cancer are poorly understood.  The aims of this study were to examine: 1) the health-related quality of life (HRQL), stress, and psychological distress in parents of young children (0-4 years) diagnosed with cancer, and 2) the associations between parent psychosocial functioning and child treatment characteristics. Methods: Parents (N= 35) with a child (19 males, 54.3%) aged 0-48 months (M= 31.06 months) who were on active cancer therapy were recruited. Parents completed questionnaires related to demographics, parent HRQL, parenting stress, post-traumatic stress symptoms, and parent psychological distress. Results: Parents reported clinically elevated parenting stress (5.88%), post-traumatic stress symptoms (18.18%), and psychological distress (21.87%). Compared to population norms, parents reported lower HRQL in the vitality (t= 5.37, p< .001), mental health (t= 4.02, p< .001), role limitation/emotional (t= 3.52, p< .001), and general health (t= 2.25, p= .025) domains. Number of days since diagnosis (β= -.35, p= .030), child surgery (β= .360, p= .023), and parent social functioning (β= -.40, p= .009) predicted parent psychological distress F(3,24)= 9.11, p< .001, R2 =.53. Conclusions: A subset of parents of young children on active cancer treatment experience clinically-elevated psychosocial symptoms. Having a child who undergoes surgery and having poor social connections put parents at risk of experiencing higher psychological distress. Supports that focus on preventing the emergence of clinically significant distress should focus on parents of young children with cancer who are most at risk of poor outcomes.


2015 ◽  
Vol 32 (11) ◽  
pp. 853-862 ◽  
Author(s):  
Juanita A. Haagsma ◽  
Annemieke C. Scholten ◽  
Teuntje M.J.C. Andriessen ◽  
Pieter E. Vos ◽  
Ed F. Van Beeck ◽  
...  

2009 ◽  
Vol 43 (8) ◽  
pp. 746-753 ◽  
Author(s):  
Markus A. Landolt ◽  
Margarete E. Vollrath ◽  
Hanspeter E. Gnehm ◽  
Felix H. Sennhauser

Objective: There is little knowledge on health-related quality of life (HRQOL) of injured children and adolescents after road traffic accidents (RTA). Although findings in injured adults suggest that post-traumatic stress symptoms (PTSS) may be important predictors of HRQOL, this issue has never been prospectively examined in children. The aim of the present study was therefore to prospectively assess HRQOL in children after RTA and specifically examine the impact of PTSS on HRQOL. Method: Sixty-eight children (aged 6.5–14.5 years) were interviewed 1 month and 1 year after an RTA using the Child PTSD Reaction Index and the Toegepast Natuurwetenschappelijk Onderzoek-Academisch Ziekenhuis Leiden (TNO-AZL) Questionnaire for Children's Health-Related Quality of Life. Parents and physicians were assessed with questionnaires. Results: Eleven children (16.2%) showed moderate to severe post-traumatic stress reactions at 1 month, and 12 children (17.6%) at 1 year. At 1 month, patients reported reduced motor functioning and autonomy and impairments in some parts of emotional functioning compared to a community sample. At 1 year all dimensions of HRQOL were within or above normal ranges. Multivariate analysis indicated that PTSS at 1 month significantly predicted HRQOL at 1 year. Conclusions: This prospective study provides evidence for a long-term negative influence of early PTSS on HRQOL in injured children. The return of injured children to pre-injury HRQOL may therefore not only depend on optimal medical care but also on awareness and timely interventions regarding PTSS.


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