Changes in quality of life and dyspnoea after hospitalization in COVID-19 patients discharged at home

Santus, Pierachille; Tursi, Francesco; Croce, Giuseppe; Simone, Chiara Di; Frassanito, Francesca; Gaboardi, Paolo; Airoldi, Andrea; Pecis, Marica; Negretto, Giangiuseppe; Radovanovic, Dejan

doi:10.4081/mrm.2020.713

Cited by 52 publications

(69 citation statements)

References 30 publications

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“…The efficacy of erdosteine in patients with COVID-19 has also been examined. In one real-life observational study, 20 patients with COVID-19-related pneumonia received usual care plus erdosteine (300 mg twice daily) for 15 days after hospital discharge following local standard operating procedures [73]. Patients reported significant improvements in health-related quality of life (HRQoL) assessed by St George's Respiratory Questionnaire and dyspnoea at rest and during daily activities assessed by the Modified Medical Research Council (mMRC) scale of dyspnoea during daily activity, the BORG scale for dyspnoea during exertion, and Visual Analogue Scale (VAS) for dyspnoea at rest.…”

Section: Evidence For Use Of Thiols In Covid-19mentioning

confidence: 99%

Use of Thiols in the Treatment of COVID-19: Current Evidence

Cazzola

Rogliani

Salvi³

et al. 2021

Lung

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There is a possible role for oxidative stress, a state characterized by an altered balance between the production of free radicals or reactive oxygen species (ROS) and antioxidant defences, in coronavirus disease 2019 (COVID-19), the genesis of which is quite complex. Excessive oxidative stress could be responsible for the alveolar damage, thrombosis, and red blood cell dysregulation observed in COVID-19. Apparently, deficiency of glutathione (GSH), a low-molecular-weight thiol that is the most important non-enzymatic antioxidant molecule and has the potential to keep the cytokine storm in check, is a plausible explanation for the severe manifestations and death in COVID-19 patients. Thiol drugs, which are considered mucolytic, also possess potent antioxidant and anti-inflammatory properties. They exhibit antibacterial activity against a variety of medically important bacteria and may be an effective strategy against influenza virus infection. The importance of oxidative stress during COVID-19 and the various pharmacological characteristics of thiol-based drugs suggest a possible role of thiols in the treatment of COVID-19. Oral and intravenous GSH, as well as GSH precursors such as N-acetylcysteine (NAC), or drugs containing the thiol moiety (erdosteine) may represent a novel therapeutic approach to block NF-kB and address the cytokine storm syndrome and respiratory distress observed in COVID-19 pneumonia patients

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Section: Evidence For Use Of Thiols In Covid-19mentioning

confidence: 99%

Use of Thiols in the Treatment of COVID-19: Current Evidence

Cazzola

Rogliani

Salvi³

et al. 2021

Lung

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show abstract

“…On the other hand, the modi ed Medical Research Council (mMRC) dyspnea scale [26][27][28] was used to rate the impact of dyspnea on daily activities over the last week on a 5-point scale, ranging from 0 ("I only get breathless with strenuous exercise") to 4 ("I am too breathless to leave the house or I am breathless when dressing"). The mMRC is considered to have low sensitivity to change, and a reduction of 1 point can be considered clinically relevant [29].…”

Section: Primary Outcomementioning

confidence: 99%

Short-term Effects of a Three-week Inpatient Post-COVID-19 Pulmonary Rehabilitation Program - a Prospective Observational Study

Hayden

Limbach

Schüler

et al. 2021

Preprint

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Background:The clinical course of coronavirus disease 2019 (COVID-19) varies distinctly. Particularly after severe or critical courses, i.e., after hospitalization, clinical manifestations frequently persist after the acute phase. However, symptoms may also persist after initially milder courses that can be treated in an outpatient setting. For patients who remain symptomatic after COVID-19, pulmonary rehabilitation (PR) is recommended. However, only few studies investigated the effectiveness of PR, especially considering different disease courses. The main objective was to evaluate the feasibility, safety, and efficacy of post-COVID-19 PR.Methods:A total of 120 post-COVID-19 patients who were referred to the Bad Reichenhall Clinic between April 2020 and January 2021 were asked to participate in this prospective observational study. PR was tailored to each patient’s individual needs and was based on the current recommendations. The primary outcome dyspnea was assessed with numerical rating scales and the modified Medical Research Council (mMRC) dyspnea scale. Secondary outcomes included other symptoms such as cough and sputum; physical capacity; lung function; fatigue; quality of life (QoL); depression; and anxiety. Furthermore, patients rated the overall effectiveness of PR and their subjective change in health status.Results:A total of 108 patients (mean age 55.6±10.1 years, 45.4% female) were included and were assigned to 3 groups depending on the referral mode (A: severe acute; B: severe after interval, C: mild after interval). At the end of PR, we detected improvements in the intensity of exertional dyspnea, physical capacity, QoL, fatigue, and depression in the overall group, with large effect sizes (Cohen’s d>0.8). Moderate effect sizes (0.5≤d<0.8) were found for resting dyspnea and the mMRC-dyspnea scale. Cohen’s d>0.4 was found for vital capacity, forced expiratory volume in one second, partial oxygen pressure, and anxiety. Significant but rather small effect sizes (0.2<d<0.4) were found for cough, sputum, pain, and other lung function parameters.Conclusions:PR is feasible, safe, and effective after acute COVID-19, which was true for all 3 groups analyzed, with a trend toward greater efficacy after severe courses of COVID-19 and an earlier start of PR after acute COVID-19. Therefore, all post-COVID-19 patients who remain symptomatic should be offered PR.Trial registration: German Clinical Trials Register, DRKS00023180. Registered 01 September 2020 – Retrospectively registered, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00023180

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“…The virus may affect different organs and body systems such as heart (damage to heart muscle, heart failure), lungs (damage to lung tissue and restrictive lung failure), brain and nervous system (anosmia, consequences of thrombo-embolic events, such as stroke, cognitive impairment), mental health (anxiety, depression, sleep disturbance) and musculoskeletal problems and fatigue [ 8 ]. Patients who recover may continue to be affected with hypoxia, shortness of breath and reduced ability to work [ 9 , 10 ]. Recent reports suggest that some patients may develop medical complications and 11%-24% of Covid-19 patients may experience long-term symptoms even after three months from the onset of Covid-19 illness [ 8 , 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

“…SF-36 (36-item Short-Form Health Survey), SF-6D (Short-Form 6 Dimension) derived from the SF-36, and EQ-5D (EuroQol- 5 Dimension)) are widely used to assess multi-dimensional domains of the health and well-being of different populations [ 15 ]. Disease specific quality of life assessment instruments related to pulmonary disease include St. George Respiratory Questionnaire (SGRQ) and Clinical COPD Questionnaire (CCQ) [ 16 , 17 ], which have been used in HRQoL assessment of Covid-19 patients [ 10 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

Impact of Covid-19 on health-related quality of life of patients: A structured review

et al. 2021

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Introduction Coronavirus disease (Covid-19) has led to a global pandemic since its emergence in December 2019. The majority of research into Covid-19 has focused on transmission, and mortality and morbidity associated with the virus. However, less attention has been given to its impact on health-related quality of life (HRQoL) of patients with Covid-19. Methods We searched for original studies published between December 2019 and Jan 2021 in PubMed, Scopus and Medline databases using a specific search strategy. We also explored literature on websites of distinguished public health organisations and hand-searched reference lists of eligible studies. The studies were screened by two reviewers according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) flowchart using pre-determined eligibility criteria. Data were synthesised, analysed descriptively and reported in line with PRISMA guidelines. Results In total, 1276 studies were identified through the search strategy. Of these, 77 studies were selected for full-text reading after screening the studies. After reading full-text, 12 eligible studies were included in this review. The majority of the studies used a generic HRQoL assessment tool; five studies used SF-36, five studies used EQ-5D-5L, and three used pulmonary disease-specific HRQoL tools (two studies used two tools each). The impact of Covid-19 on HRQoL was found to be considerable in both Acute Covid and Long Covid patients. Higher impact on HRQoL was reported in Acute Covid, females, older ages, patients with more severe disease and patients from low-income countries. Conclusion The impact of Covid-19 on HRQoL of Acute and Long Covid patients is substantial. There was disproportional impact on patients by gender, age, severity of illness and study country. The long-term impact of Covid-19 is still in its initial stage. The findings of the review may be useful to researchers, policymakers, and clinicians caring for people following Covid-19 infection.

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Changes in quality of life and dyspnoea after hospitalization in COVID-19 patients discharged at home

Cited by 52 publications

References 30 publications

Use of Thiols in the Treatment of COVID-19: Current Evidence

Use of Thiols in the Treatment of COVID-19: Current Evidence

Short-term Effects of a Three-week Inpatient Post-COVID-19 Pulmonary Rehabilitation Program - a Prospective Observational Study

Impact of Covid-19 on health-related quality of life of patients: A structured review

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