Prevalence and risk factors of disability and anxiety in a retrospective cohort of 432 survivors of Coronavirus Disease-2019 (Covid-19) from China.

Autor: Zhu S; Rehabilitation Medical Center, West China Hospital, Sichuan University, Chengdu, China.; Rehabilitation Medicine Key Laboratory of Sichuan Province, Sichuan University, Chengdu, China., Gao Q; Rehabilitation Medical Center, West China Hospital, Sichuan University, Chengdu, China.; Rehabilitation Medicine Key Laboratory of Sichuan Province, Sichuan University, Chengdu, China., Yang L; Rehabilitation Medical Center, West China Hospital, Sichuan University, Chengdu, China.; Rehabilitation Medicine Key Laboratory of Sichuan Province, Sichuan University, Chengdu, China., Yang Y; Rehabilitation Medical Center, West China Hospital, Sichuan University, Chengdu, China.; Rehabilitation Medicine Key Laboratory of Sichuan Province, Sichuan University, Chengdu, China., Xia W; Hubei Hospital of Integrated Traditional Chinese and Western Medicine, Wuhan, Hubei, China., Cai X; Henan Provincial People's Hospital, Zhengzhou, Henan, China., Hui Y; The Second Affiliated Hospital, Medical College of Xi'an Jiaotong University, Xian, Shanxi, China., Zhu D; Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, China., Zhang Y; Qilu Hospital of Shandong University, Jinan, Shandong, China., Zhang G; The First Affiliated Hospital, School of Medicine, Shihezi University, Xinjiang, China., Wu S; The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China., Wang Y; Chongqing Three Gorges Central Hospital, Chongqing, China., Zhou Z; Inner Mongolia Autonomous Region Baotou Central Hospital, Baotou, China., Liu H; General Hospital of General Bureau of Agricultural Reclamation of Heilongjiang Province, Harbin, China., Zhang C; The Second Xiangya Hospital of Central South University, Changsha, China., Zhang B; Nanchong Central Hospital, Nanchong, Sichuan, China., Yang J; Garze People's Hospital, Garze Tibetan Autonomous Prefecture, Sichuan, China., Feng M; Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China., Ni Z; Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China., Chen B; Rehabilitation Medical Center, West China Hospital, Sichuan University, Chengdu, China., Du C; Rehabilitation Medical Center, West China Hospital, Sichuan University, Chengdu, China.; Rehabilitation Medicine Key Laboratory of Sichuan Province, Sichuan University, Chengdu, China., He H; Rehabilitation Medical Center, West China Hospital, Sichuan University, Chengdu, China.; Rehabilitation Medicine Key Laboratory of Sichuan Province, Sichuan University, Chengdu, China., Qu Y; Rehabilitation Medical Center, West China Hospital, Sichuan University, Chengdu, China.; Rehabilitation Medicine Key Laboratory of Sichuan Province, Sichuan University, Chengdu, China., Wei Q; Rehabilitation Medical Center, West China Hospital, Sichuan University, Chengdu, China.; Rehabilitation Medicine Key Laboratory of Sichuan Province, Sichuan University, Chengdu, China., He C; Rehabilitation Medical Center, West China Hospital, Sichuan University, Chengdu, China.; Rehabilitation Medicine Key Laboratory of Sichuan Province, Sichuan University, Chengdu, China.; Institute for Disaster Management and Reconstruction of Sichuan University and Hong Kong Polytechnic University, Sichuan University, Chengdu, China., Reinhardt JD; Institute for Disaster Management and Reconstruction of Sichuan University and Hong Kong Polytechnic University, Sichuan University, Chengdu, China.; Swiss Paraplegic Research, Nottwil, Switzerland.; Department of Health Sciences and Medicine, University of Lucerne, Luzern, Switzerland.; Xidian Hospital Group, Xi'an, Shaanxi, China.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2020 Dec 17; Vol. 15 (12), pp. e0243883. Date of Electronic Publication: 2020 Dec 17 (Print Publication: 2020).
DOI: 10.1371/journal.pone.0243883
Abstrakt: Objective: To estimate the prevalence of disability and anxiety in Covid-19 survivors at discharge from hospital and analyze relative risk by exposures.
Design: Multi-center retrospective cohort study.
Setting: Twenty-eight hospitals located in eight provinces of China.
Methods: A total of 432 survivors with laboratory-confirmed SARS CoV-2 infection participated in this study. At discharge, we assessed instrumental activities of daily living (IADL) with Lawton's IADL scale, dependence in activities of daily living (ADL) with the Barthel Index, and anxiety with Zung's self-reported anxiety scale. Exposures included comorbidity, smoking, setting (Hubei vs. others), disease severity, symptoms, and length of hospital stay. Other risk factors considered were age, gender, and ethnicity (Han vs. Tibetan).
Results: Prevalence of at least one IADL problem was 36.81% (95% CI: 32.39-41.46). ADL dependence was present in 16.44% (95% CI: 13.23-20.23) and 28.70% (95% CI: 24.63-33.15) were screened positive for clinical anxiety. Adjusted risk ratio (RR) of IADL limitations (RR 2.48, 95% CI: 1.80-3.40), ADL dependence (RR 2.07, 95% CI 1.15-3.76), and probable clinical anxiety (RR 2.53, 95% CI 1.69-3.79) were consistently elevated in survivors with severe Covid-19. Age was an additional independent risk factor for IADL limitations and ADL dependence; and setting (Hubei) for IADL limitations and anxiety. Tibetan ethnicity was a protective factor for anxiety but a risk factor for IADL limitations.
Conclusion: A significant proportion of Covid-19 survivors had disability and anxiety at discharge from hospital. Health systems need to be prepared for an additional burden resulting from rehabilitation needs of Covid-19 survivors.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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