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Ariza M, Cano N, Segura B, Bejar J, Barrué C, Cortés CU, Junqué C, Garolera M. Cognitive and emotional predictors of quality of life and functioning after COVID-19. Ann Clin Transl Neurol 2024; 11:302-320. [PMID: 38130039 PMCID: PMC10863915 DOI: 10.1002/acn3.51952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/31/2023] [Accepted: 11/08/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVE A long-term decline in health-related quality of life (HRQoL) has been reported after coronavirus disease 2019 (COVID-19). Studies with people with persistent symptoms showed inconsistent outcomes. Cognition and emotion are important determinants in HRQoL, but few studies have examined their prognostic significance for HRQoL and functionality in post-COVID patients with persisting symptoms. We aimed to describe QoL, HRQoL, and functioning in individuals post-COVID with varying COVID-19 severities and to investigate the predictive value of cognitive and emotional variables for QoL, HRQoL, and functioning. METHODS In total, 492 participants (398 post-COVID and 124 healthy controls) underwent a neurobehavioral examination that included assessments of cognition, mood, QoL/HRQoL (WHOQOL-BREF, EQ-5D), and functioning (WHODAS-II). Analysis of covariance and linear regression models were used to study intergroup differences and the relationship between cognitive and emotional variables and QoL and functioning. RESULTS The Physical and Psychological dimensions of WHOQoL, EQ-5D, and WHODAS Cognition, Mobility, Life Activities, and Participation dimensions were significantly lower in post-COVID groups compared with a control group. Regression models explaining 23.9%-53.9% of variance were obtained for the WHOQoL-BREF dimensions and EQ-5D, with depressive symptoms, post-COVID symptoms, employment status, income, and mental speed processing as main predictors. For the WHODAS, models explaining 17%-60.2% of the variance were obtained. Fatigue, depressive symptoms, mental speed processing, and post-COVID symptoms were the main predictors. INTERPRETATION QoL/HRQoL and functioning after COVID-19 in individuals with persistent symptoms were lower than in non-affected persons. Depressive symptoms, fatigue, and slower mental processing speed were predictors of lower QoL/HRQoL and functioning.
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Affiliation(s)
- Mar Ariza
- Grup de Recerca en Cervell, Cognició i ConductaConsorci Sanitari de Terrassa (CST)TerrassaSpain
- Unitat de Psicologia Mèdica, Departament de MedicinaUniversitat de Barcelona (UB)BarcelonaSpain
| | - Neus Cano
- Grup de Recerca en Cervell, Cognició i ConductaConsorci Sanitari de Terrassa (CST)TerrassaSpain
- Departament de Ciències BàsiquesUniversitat Internacional de Catalunya (UIC)Sant Cugat del VallèsSpain
| | - Bàrbara Segura
- Unitat de Psicologia Mèdica, Departament de MedicinaUniversitat de Barcelona (UB)BarcelonaSpain
- Institut de NeurociènciesUniversitat de Barcelona (UB)BarcelonaSpain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)BarcelonaSpain
| | - Javier Bejar
- Departament de Ciències de la ComputacióUniversitat Politècnica de Catalunya‐BarcelonaTechBarcelonaSpain
| | - Cristian Barrué
- Departament de Ciències de la ComputacióUniversitat Politècnica de Catalunya‐BarcelonaTechBarcelonaSpain
| | - Claudio Ulises Cortés
- Departament de Ciències de la ComputacióUniversitat Politècnica de Catalunya‐BarcelonaTechBarcelonaSpain
| | - Carme Junqué
- Unitat de Psicologia Mèdica, Departament de MedicinaUniversitat de Barcelona (UB)BarcelonaSpain
- Institut de NeurociènciesUniversitat de Barcelona (UB)BarcelonaSpain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)BarcelonaSpain
| | - Maite Garolera
- Grup de Recerca en Cervell, Cognició i ConductaConsorci Sanitari de Terrassa (CST)TerrassaSpain
- Neuropsychology UnitConsorci Sanitari de Terrassa (CST)TerrassaSpain
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Chia S, Xia J, Kwan YH, Lim ZY, Tan CS, Low SG, Xu B, Loo YX, Kong LY, Koh CW, Towle RM, Lim SF, Yoon S, Seah SSY, Low LL. Evaluating the association of COVID-19 restrictions on discharge planning and post-discharge outcomes in the community hospital and Singapore regional health system. FRONTIERS IN HEALTH SERVICES 2023; 3:1147698. [PMID: 37744642 PMCID: PMC10513784 DOI: 10.3389/frhs.2023.1147698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 08/24/2023] [Indexed: 09/26/2023]
Abstract
Objectives The COVID-19 is a global health issue with widespread impact around the world, and many countries initiated lockdowns as part of their preventive measures. We aim to quantify the duration of delay in discharge to community from Community Hospitals, as well as quantify adverse patient outcomes post discharge pre and during lockdown period. Design and methods We conducted a before-after study comparing the length of stay in Community Hospitals, unscheduled readmissions or Emergency Department attendance, patients' quality of life using EQ5D-5l, number and severity of falls, in patients admitted and discharged before and during lockdown period. Results The average length of stay in the lockdown group (27.77 days) were significantly longer than that of the pre-lockdown group (23.76 days), p = 0.003. There were similar proportions of patients with self-reported falls post discharge between both groups. Patients in the pre-lockdown group had slightly better EQ-5D-5l Index score at 0.55, compared to the lockdown study group at 0.49. Half of the patients in both groups were referred to Community Care Services on discharge. Conclusion Our study would help in developing a future systematic preparedness guideline and contingency plans in times of disease outbreak and other similar public health emergencies.
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Affiliation(s)
- Shermain Chia
- Post-Acute and Continuing Care, Outram Community Hospital, Singapore, Singapore
| | - Jiawen Xia
- Research and Translational Innovation Office, Singhealth Community Hospitals, Singapore, Singapore
| | - Yu Heng Kwan
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Zhui Ying Lim
- Population Health & Integrated Care Office, Singapore General Hospital, Singapore, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Sher Guan Low
- Post-Acute and Continuing Care, Sengkang Community Hospital, Singapore, Singapore
| | - Bangyu Xu
- Post-Acute and Continuing Care, Sengkang Community Hospital, Singapore, Singapore
| | - Yu Xian Loo
- Post-Acute and Continuing Care, Outram Community Hospital, Singapore, Singapore
| | - Lai Yee Kong
- Medical Social Services, Sengkang Community Hospital, Singapore, Singapore
| | - Chee Wai Koh
- Medical Social Services, Outram Community Hospital, Singapore, Singapore
| | - Rachel Marie Towle
- Specialty Nursing, Population Health & Integrated Care Office, Regional Health System, Singapore, Singapore
| | - Su Fee Lim
- Regional Health System Community Nursing, Population Health & Integrated Care Office, Singapore General Hospital, Singapore, Singapore
| | - Sungwon Yoon
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Sharna Si Ying Seah
- Research and Translational Innovation Office, Singhealth Community Hospitals, Singapore, Singapore
| | - Lian Leng Low
- Post-Acute and Continuing Care, Outram Community Hospital, Singapore, Singapore
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Lopez-de-Andres A, Jimenez-Garcia R, Carabantes-Alarcon D, Hernández-Barrera V, de-Miguel-Yanes JM, de-Miguel-Diez J, Zamorano-Leon JJ, del-Barrio JL, Cuadrado-Corrales N. Use of Cardiac Procedures in People with Diabetes during the COVID Pandemic in Spain: Effects on the In-Hospital Mortality. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:844. [PMID: 36613166 PMCID: PMC9819421 DOI: 10.3390/ijerph20010844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/16/2022] [Accepted: 12/30/2022] [Indexed: 06/17/2023]
Abstract
We aimed to assess the effect of the COVID-19 pandemic in Spain on people with diabetes undergoing cardiac procedures, such as coronary artery bypass graft (CABG), percutaneous coronary intervention (PCI), open surgical valve replacement (OSVR), and transcatheter valve implantation (TCVI). We compared the year 2019 with the year 2020. We conducted an observational study using data from the Spanish National Hospital Discharge Database from 1 January 2019 to 31 December 2020. In 2020, a total of 21,067 cardiac procedures were performed on people with diabetes compared with 24,675 in the previous year. The use of CABG, PCI, OSVR and TCVI decreased from 2019 to 2020 by 13.9%, 14.8%, 21.4% and 2.9%, respectively. In 2020, patients had a significantly higher mean Charlson Comorbidity Index than in 2019 for all the cardiac procedures analyzed. In-hospital mortality (IHM) was higher (p > 0.05) for all the procedures in the year 2020. Over the entire period, female sex was a significant risk factor for IHM among those who underwent CABG, PCI and OSVR (OR 1.94, 95%CI 1.41-2.66; OR 1.19, 95%CI 1.05-1.35; and OR 1.79, 95%CI 1.38-2.32, respectively). The sensitivity analysis including two more years, 2017 and 2018, confirmed that female patients and comorbidity were risk factors for IHM in patients with diabetes regardless of whether it was during the pandemic era or before. We conclude that the frequency of cardiac procedures among people with diabetes declined in 2020. IHM did not change significantly in the COVID-19 era.
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Affiliation(s)
- Ana Lopez-de-Andres
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Rodrigo Jimenez-Garcia
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - David Carabantes-Alarcon
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Valentín Hernández-Barrera
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Alcorcón, 28922 Madrid, Spain
| | - José M. de-Miguel-Yanes
- Internal Medicine Department, Hospital General Gregorio Marañón, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), 28007 Madrid, Spain
| | - Javier de-Miguel-Diez
- Respiratory Department, Hospital General Gregorio Marañón, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), 28007 Madrid, Spain
| | - Jose J. Zamorano-Leon
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Jose L. del-Barrio
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Alcorcón, 28922 Madrid, Spain
| | - Natividad Cuadrado-Corrales
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
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Mercieca-Bebber R, Campbell R, Fullerton DJ, Kleitman S, Costa DSJ, Candelaria D, Tait MA, Norman R, King M. Health-related quality of life of Australians during the 2020 COVID-19 pandemic: a comparison with pre-pandemic data and factors associated with poor outcomes. Qual Life Res 2023; 32:339-355. [PMID: 35989367 PMCID: PMC9393100 DOI: 10.1007/s11136-022-03222-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2022] [Indexed: 12/02/2022]
Abstract
PURPOSE Compare the health-related quality of life (HRQL) of the Australian general population during the COVID-19 pandemic (2020) with pre-pandemic data (2015-2016) and identify pandemic-related and demographic factors associated with poorer HRQL. METHODS Participants were quota sampled from an online panel by four regions (defined by active COVID-19 case numbers); then by age and sex. Participants completed an online survey about their HRQL [EORTC QLQ-C30 questionnaire and General Health Question (GHQ)], demographic characteristics, and the impact of the pandemic on daily life. HRQL scores were compared to a 2015-2016 reference sample using independent t-tests, adjusted for multiple testing. Associations between 22 pre-specified factors (pandemic-related and demographic) and 15 QLQ-C30 domains and GHQ, were assessed with multiple regressions. RESULTS Most domains were statistically significantly worse for the 2020 sample (n = 1898) compared to the reference sample (n = 1979), except fatigue and pain. Differences were largest for the youngest group (18-29 years) for cognitive functioning, nausea, diarrhoea, and financial difficulties. Emotional functioning was worse for 2020 participants aged 18-59, but not for those 60 +. All models were statistically significant at p < .001; the most variance was explained for emotional functioning, QLQ-C30 global health/QOL, nausea/vomiting, GHQ, and financial difficulties. Generally, increased workload, negative COVID-19 impacts, COVID-19-related worries, and negative attitudes towards public health order compliance were associated with poorer HRQL outcomes. CONCLUSION During the COVID-19 pandemic, Australians reported poorer HRQL relative to a pre-pandemic sample. Risk factors for poor HRQL outcomes included greater negative pandemic-related impacts, poorer compliance attitudes, and younger age. TRIAL REGISTRATION ANZCTR number is: ACTRN12621001240831. Web address of your trial: https://www.anzctr.org.au/ACTRN12621001240831.aspx . Date submitted: 26/08/2021 2:56:53 PM. Date registered: 14/09/2021 9:40:31 AM. Registered by: Margaret-Ann Tait. Principal Investigator: Madeleine King.
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Affiliation(s)
- Rebecca Mercieca-Bebber
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, Australia. .,Faculty of Medicine and Health, The University of Sydney, Sydney, Australia. .,Sydney Quality of Life Office, School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia.
| | - Rachel Campbell
- grid.1013.30000 0004 1936 834XSydney Quality of Life Office, School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
| | - Dayna Jan Fullerton
- grid.1013.30000 0004 1936 834XSydney Quality of Life Office, School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
| | - Sabina Kleitman
- grid.1013.30000 0004 1936 834XSchool of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
| | - Daniel S. J. Costa
- grid.1013.30000 0004 1936 834XSchool of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
| | - Dion Candelaria
- grid.1013.30000 0004 1936 834XSydney Quality of Life Office, School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia ,grid.1013.30000 0004 1936 834XSusan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Margaret Ann Tait
- grid.1013.30000 0004 1936 834XSydney Quality of Life Office, School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
| | - Richard Norman
- grid.1032.00000 0004 0375 4078School of Population Health, Curtin University, Perth, WA Australia
| | - Madeleine King
- grid.1013.30000 0004 1936 834XSydney Quality of Life Office, School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
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Quality of Life in Patients with Pancreatic Cancer before and during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063731. [PMID: 35329416 PMCID: PMC8948872 DOI: 10.3390/ijerph19063731] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/13/2022] [Accepted: 03/18/2022] [Indexed: 01/05/2023]
Abstract
Background: Coronavirus disease 19 (COVID-19) substantially affects cancer patients due to adverse outcomes and disruptions in cancer care. Recent studies have indicated the additional stress and anxiety burden arising from the pandemic and impairing quality of life in this vulnerable group of patients. However, patients with cancer represent a heterogenous group. Therefore, we conducted a study on patients with pancreatic cancer, requiring demanding surgical interventions and chemotherapy regimens due to its aggressive tumor biology, to explore the pandemic’s impact on quality of life within this homogenous cohort. Methods: In a descriptive observational study, the quality of life of patients who had undergone pancreatic surgery for tumor resection at our institution between 2014 and the beginning of the pandemic in March 2020 was assessed. For HRQoL measurement, we used the European Organisation for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30), comparing their situation before the pandemic and since its beginning. An additional self-developed questionnaire was applied to assess the life circumstances during the pandemic. Results: Our cohort included 26 patients. Scores from the survey in HRQoL revealed no significant changes over time between before and during the pandemic. A medium deterioration in HRQoL was apparent in social functioning, as well as a small deterioration in role functioning and emotional functioning. Worries concerning a potential impact of COVID-19 on personal health were expressed. Psychological limitations in QoL were mainly attributed to the pandemic, whereas physical limitations in QoL were rather associated with the underlying disease of pancreatic cancer. Conclusion: The COVID-19 pandemic is causing considerable social and emotional distress among pancreatic cancer patients. These patients will benefit from psychological support during the pandemic and beyond. Long-time survivors of pancreatic cancer, such as those included in our cohort, appear to have improved resilience facing the psychosocial challenges of the pandemic. For pancreatic cancer, surgical care is considered the cornerstone of treatment. Prolonged delays in healthcare cause serious damage to mental and physical health. To date, the longer-term clinical consequences are not known and can only be estimated. The potential tragic outcome for the vulnerable group of pancreatic cancer patients highlights the urgency of timely healthcare decisions to be addressed in the future.
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