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Association between acute disease severity and one-year quality of life among post-hospitalisation COVID-19 patients: Coalition VII prospective cohort study

2023; Springer Science+Business Media; Volume: 49; Issue: 2 Linguagem: Inglês

10.1007/s00134-022-06953-1

1432-1238

Régis Goulart Rosa, Alexandre Biasi Cavalcanti, Luciano César Pontes Azevedo, Viviane Cordeiro Veiga, Denise de Souza, Rosa da Rosa Minho dos Santos, Raíne Fogliati de Carli Schardosim, Gabriela Soares Rech, Geraldine Trott, Daniel Schneider, Caroline Cabral Robinson, Tainá Aparecida Haubert, Victoria Emanuele Lobo Pallaoro, Liége Gregoletto Brognoli, Ana Paula de Souza, Lauren Sezerá Costa, Bruna Machado Barroso, Melissa Pezzetti Pelliccioli, Janine Gonzaga, Nicole dos Santos Studier, Ana Paula Aquistapase Dagnino, Juliana de Mesquita Neto, Sabrina Souza da Silva, Bruna dos Passos Gimenes, Vanessa Brzoskowski dos Santos, Gabriel Pozza Estivalete, Carolina de Moraes Pellegrino, Carísi Anne Polanczyk, Letícia Kawano-Dourado, Bruno Martins Tomazini, Thiago Lisboa, Cassiano Teixeira, Fernando G. Zampieri, Alexandre Prehn Zavascki, Bernard J. Gersh, Álvaro Avezum, Flávia Ribeiro Machado, Otávio Berwanger, Renato D. Lópes, Maicon Falavigna,

Health Systems, Economic Evaluations, Quality of Life

To assess the association between acute disease severity and 1-year quality of life in patients discharged after hospitalisation due to coronavirus disease 2019 (COVID-19). We conducted a prospective cohort study nested in 5 randomised clinical trials between March 2020 and March 2022 at 84 sites in Brazil. Adult post-hospitalisation COVID-19 patients were followed for 1 year. The primary outcome was the utility score of EuroQol five-dimension three-level (EQ-5D-3L). Secondary outcomes included all-cause mortality, major cardiovascular events, and new disabilities in instrumental activities of daily living. Adjusted generalised estimating equations were used to assess the association between outcomes and acute disease severity according to the highest level on a modified ordinal scale during hospital stay (2: no oxygen therapy; 3: oxygen by mask or nasal prongs; 4: high-flow nasal cannula oxygen therapy or non-invasive ventilation; 5: mechanical ventilation). 1508 COVID-19 survivors were enrolled. Primary outcome data were available for 1156 participants. At 1 year, compared with severity score 2, severity score 5 was associated with lower EQ-5D-3L utility scores (0.7 vs 0.84; adjusted difference, − 0.1 [95% CI − 0.15 to − 0.06]); and worse results for all-cause mortality (7.9% vs 1.2%; adjusted difference, 7.1% [95% CI 2.5%–11.8%]), major cardiovascular events (5.6% vs 2.3%; adjusted difference, 2.6% [95% CI 0.6%–4.6%]), and new disabilities (40.4% vs 23.5%; adjusted difference, 15.5% [95% CI 8.5%–22.5]). Severity scores 3 and 4 did not differ consistently from score 2. COVID-19 patients who needed mechanical ventilation during hospitalisation have lower 1-year quality of life than COVID-19 patients who did not need mechanical ventilation during hospitalisation.