1
|
Long-Term Outcomes of Patients with Coronavirus Disease 2019 at One Year after Hospital Discharge. J Clin Med 2021; 10:jcm10132945. [PMID: 34209085 PMCID: PMC8269002 DOI: 10.3390/jcm10132945] [Citation(s) in RCA: 90] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 06/26/2021] [Accepted: 06/27/2021] [Indexed: 12/29/2022] Open
Abstract
Background: The long-term effects of COVID-19 remain largely unclear. This study aims to investigate post-acute health consequences and mortality one year after hospital discharge. Methods: All surviving adult patients who were discharged after hospital admission due to acute COVID-19 in the first wave of the pandemic underwent a comprehensive interview. Functional assessment was performed in patients aged over 65. Clinical and hospital records were reviewed and mortality causes assessed. Results: A total of 587 patients with COVID-19 were discharged from hospital, including 266 after hospital admission and 321 from the emergency room. Mortality within the following year occurred in 34/266 (12.8%) and 10/321 (3.1%), respectively, due to causes directly or possibly related to COVID-19 in 20.5% and 25% of patients. Post-COVID-19 syndrome was assessed in 543 patients at one year from discharge. Any clinical complaint was reported by 90.1% of patients who needed hospitalization and 80.4% of those discharged from the emergency room (p = 0.002), with breathlessness (41.6%), tiredness (35.4%), ageusia (30.2%), and anosmia (26.3%) being the most common complaints. Ongoing symptoms attributed to COVID-19 were reported by 66.8% and 49.5% of patients, respectively (p < 0.001). Newly developed COPD, asthma, diabetes, heart failure, and arthritis—as well as worsening of preexisting comorbidities—were found. Conclusions: One-year mortality among survivors of acute COVID-19 was 7.5%. A significant proportion of COVID-19 patients experienced ongoing symptoms at 1 year from onset of the disease.
Collapse
|
2
|
Salvi SS, Dhar R, Mahesh PA, Udwadia ZF, Behra D. COPD Management during the COVID-19 pandemic. Lung India 2021; 38:S80-S85. [PMID: 33686988 PMCID: PMC8104354 DOI: 10.4103/lungindia.lungindia_685_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Sundeep Santosh Salvi
- Department of Clinical Research, Pulmocare Research and Education (PURE) Foundation, Pune, India
| | - Raja Dhar
- Department of Respiratory Medicine, National Allergy Asthma Bronchitis Institute, Kolkota, West Bengal, India
| | - P A Mahesh
- Department of Respiratory Medicine, JSS Medical College, Mysuru, Karnataka, India
| | - Zarir Farooq Udwadia
- Department of Respiratory Medicine, Hinduja Hospital and Research Centre, Mumbai, Maharashtra, India
| | - Digambar Behra
- Department of Pulmonary Medicine, PGIMER, Chandigarh, India
| |
Collapse
|
3
|
Schneeberger T, Jarosch I, Koczulla AR. [What can pulmonary rehabilitation accomplish?]. Dtsch Med Wochenschr 2020; 145:1782-1785. [PMID: 33254254 DOI: 10.1055/a-1129-3375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The Global Initiative for Chronic Obstructive Lung Disease (GOLD) has stated that pulmonary rehabilitation (PR) is the most effective therapeutic intervention to reduce dyspnoea and to improve physical performance and quality of life for patients with obstructive lung disease.New innovative studies raised in the area of PR:1) Pulmonary fibrosis & asthma bronchiale - While PR is recommended for chronic respiratory diseases other than COPD (chronic obstructive pulmonary disease) in the respective disease-specific treatment guidelines, PR in some pathologies is underrated. For example, there is a growing body of evidence showing the effectiveness of structured and multidisciplinary PR programs in pulmonary fibrosis and asthma bronchial patients;2) Coronavirus SARS-CoV-2 - There is preliminary evidence that COVID-19 patients can benefit from a PR program. The current COVID-19 position paper of the German Respiratory Society e. V. (DGP) regarding PR recommendations suggests that early rehabilitative therapies are already indicated during hospitalisation on the normal or intensive care unit and that rehabilitative interventions should be continued after discharge as a follow-up treatment in PR centres in order to reduce long-term consequences of COVID-19 disease;3) Telehealth meets PR - To further improve the effectiveness of PR in COPD patients using recent technologies, a supplementary "digital exercise program" can contribute to greater benefits compared to PR alone.
Collapse
Affiliation(s)
- Tessa Schneeberger
- Philipps-Universität Marburg, Pneumologische Rehabilitation, Deutsches Zentrum für Lungenforschung (DZL) - Standort Schönau, Marburg.,Forschungsinstitut für pneumologische Rehabilitation, Schön-Klinik Berchtesgadener Land, Schönau am Königssee
| | - Inga Jarosch
- Philipps-Universität Marburg, Pneumologische Rehabilitation, Deutsches Zentrum für Lungenforschung (DZL) - Standort Schönau, Marburg.,Forschungsinstitut für pneumologische Rehabilitation, Schön-Klinik Berchtesgadener Land, Schönau am Königssee
| | - Andreas Rembert Koczulla
- Philipps-Universität Marburg, Pneumologische Rehabilitation, Deutsches Zentrum für Lungenforschung (DZL) - Standort Schönau, Marburg.,Forschungsinstitut für pneumologische Rehabilitation, Schön-Klinik Berchtesgadener Land, Schönau am Königssee.,Lehrkrankenhaus der Paracelsus Medizinische Privatuniversität Salzburg, Salzburg
| |
Collapse
|
4
|
Wu R, Ai S, Cai J, Zhang S, Qian ZM, Zhang Y, Wu Y, Chen L, Tian F, Li H, Li M, Lin H. Predictive Model and Risk Factors for Case Fatality of COVID-19: A Cohort of 21,392 Cases in Hubei, China. Innovation (N Y) 2020; 1:100022. [PMID: 33521759 PMCID: PMC7832941 DOI: 10.1016/j.xinn.2020.100022] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 07/21/2020] [Indexed: 01/08/2023] Open
Abstract
An increasing number of patients are being killed by coronavirus disease 2019 (COVID-19), however, risk factors for the fatality of COVID-19 remain unclear. A total of 21,392 COVID-19 cases were recruited in the Hubei Province of China between December 2019 and February 2020, and followed up until March 18, 2020. We adopted Cox regression models to investigate the risk factors for case fatality and predicted the death probability under specific combinations of key predictors. Among the 21,392 patients, 1,020 (4.77%) died of COVID-19. Multivariable analyses showed that factors, including age (≥60 versus <45 years, hazard ratio [HR] = 7.32; 95% confidence interval [CI], 5.42, 9.89), sex (male versus female, HR = 1.31; 95% CI, 1.15, 1.50), severity of the disease (critical versus mild, HR = 39.98; 95% CI, 29.52, 48.86), comorbidity (HR = 1.40; 95% CI, 1.23, 1.60), highest body temperature (>39°C versus <39°C, HR = 1.28; 95% CI, 1.09, 1.49), white blood cell counts (>10 × 109/L versus (4–10) × 109/L, HR = 1.69; 95% CI, 1.35, 2.13), and lymphocyte counts (<0.8 × 109/L versus (0.8–4) × 109/L, HR = 1.26; 95% CI, 1.06, 1.50) were significantly associated with case fatality of COVID-19 patients. Individuals of an older age, who were male, with comorbidities, and had a critical illness had the highest death probability, with 21%, 36%, 46%, and 54% within 1–4 weeks after the symptom onset. Risk factors, including demographic characteristics, clinical symptoms, and laboratory factors were confirmed to be important determinants of fatality of COVID-19. Our predictive model can provide scientific evidence for a more rational, evidence-driven allocation of scarce medical resources to reduce the fatality of COVID-19. 21,392 COVID-19 patients constituted one of the largest cohort studies to date Elderly male patients with critical illness and comorbidities had higher death rate The death probability increased with time, which was evident for critically ill patients The highest death probability within 1 month can reach 54% by the predictive model The predictive model could guide the allocation of medical resources
Collapse
Affiliation(s)
- Ran Wu
- Institute of Preventive Medicine Information, Hubei Provincial Center for Disease Control and Prevention, 6 Zhuodaoquan North Road, Wuhan, Hubei 430079, China
| | - Siqi Ai
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou, Guangdong 510080, China
| | - Jing Cai
- Institute of Preventive Medicine Information, Hubei Provincial Center for Disease Control and Prevention, 6 Zhuodaoquan North Road, Wuhan, Hubei 430079, China
| | - Shiyu Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou, Guangdong 510080, China
| | - Zhengmin Min Qian
- College for Public Health & Social Justice, Saint Louis University, St. Louis, MO, USA
| | - Yunquan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Yinglin Wu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou, Guangdong 510080, China
| | - Lan Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou, Guangdong 510080, China
| | - Fei Tian
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou, Guangdong 510080, China
| | - Huan Li
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou, Guangdong 510080, China
| | - Mingyan Li
- Institute of Preventive Medicine Information, Hubei Provincial Center for Disease Control and Prevention, 6 Zhuodaoquan North Road, Wuhan, Hubei 430079, China
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou, Guangdong 510080, China
| |
Collapse
|
6
|
Glöckl R, Buhr-Schinner H, Koczulla AR, Schipmann R, Schultz K, Spielmanns M, Stenzel N, Dewey S. [Recommendations from the German Respiratory Society for Pulmonary Rehabilitation in Patients with COVID-19]. Pneumologie 2020; 74:496-504. [PMID: 32583378 PMCID: PMC7516360 DOI: 10.1055/a-1193-9315] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Vor dem Hintergrund der Pandemie durch Infektionen mit dem SARS-CoV-2 hat die Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin (DGP e. V.) die Sektion 12 „Rehabilitation, Prävention und Tabakkontrolle“ beauftragt, Empfehlungen zur Umsetzung pneumologischer Rehabilitation bei Patienten nach COVID-19 zu erstellen. Dieses Positionspapier basiert auf dem momentanen aktuellen Wissen, das sich täglich weiterentwickelt. Neben einer Beschreibung der gesundheitlichen Folgen von COVID-19 wird die Indikationsstellung aufgezeigt. Rehabilitative Therapien bei COVID-19 sind bereits auf der Normalstation bzw. Intensivstation indiziert, setzen sich fort als pneumologische Frührehabilitation im Akutkrankenhaus und als Anschlussheilbehandlung oder Reha-Heilverfahren in pneumologischen Rehabilitationskliniken. Im Fokus dieses Positionspapiers stehen Empfehlungen zur inhaltlichen Durchführung einer multimodalen, interdisziplinären pneumologischen Rehabilitation bei COVID-19.
Collapse
Affiliation(s)
- R Glöckl
- Schön Klinik Berchtesgadener Land, Forschungsinstitut für Pneumologische Rehabilitation, Schönau am Königssee.,Philipps-Universität Marburg, Abteilung für Pneumologische Rehabilitation, Deutsches Zentrum für Lungenforschung (DZL) Marburg
| | - H Buhr-Schinner
- Ostseeklinik Schönberg-Holm, Abteilung Pneumologie, Schönberg
| | - A R Koczulla
- Schön Klinik Berchtesgadener Land, Forschungsinstitut für Pneumologische Rehabilitation, Schönau am Königssee.,Philipps-Universität Marburg, Abteilung für Pneumologische Rehabilitation, Deutsches Zentrum für Lungenforschung (DZL) Marburg.,Lehrkrankenhaus Paracelsus Medizinische Privatuniversität, Salzburg, Österreich
| | - R Schipmann
- Klinik Martinusquelle, Abteilung Pneumologie und Kardiologie, MZG Bad Lippspringe, Bad Lippspringe
| | - K Schultz
- Klinik Bad Reichenhall der Deutschen Rentenversicherung Bayern Süd, Zentrum für Rehabilitation, Pneumologie und Orthopädie, Bad Reichenhall
| | - M Spielmanns
- Pneumologie Zürcher RehaZentren Klinik Wald, Schweiz und Medizinische Fakultät, Lehrstuhl für Pneumologie Universität Witten-Herdecke, Witten
| | - N Stenzel
- Psychologische Hochschule Berlin (PHB), Berlin
| | - S Dewey
- Strandklinik St. Peter-Ording, Abteilung für Pneumologie, St. Peter-Ording
| |
Collapse
|