COVID-19 emergency: Changes in quality of life perception in patients with chronic liver disease-An Italian single-centre study

Abstract

BACKGROUND In December 2019, the coronavirus disease-2019 (COVID-19) emerged and rapidly spread worldwide, becoming a global health threat and having a tremendous impact on the quality of life (QOL) of individuals. AIM To evaluate the awareness of patients with chronic liver disease (CLD) regarding the COVID-19 emergency and how it impacted on their QOL. METHODS Patients with an established diagnosis of CLD (cirrhosis, autoimmune hepatitis, primary biliary cholangitis, and primary sclerosing cholangitis) who had been evaluated at our Outpatient Liver Disease Clinic during the 6-mo period preceding the start of Italian lockdown (March 8, 2020) were enrolled. Participants were asked to complete a two-part questionnaire, administered by telephone according to governmental restrictions: The first section assessed patients’ basic knowledge regarding COVID-19, and the second evaluated the impact of the COVID-19 emergency on their QOL. We used the Italian version of the CLD questionnaire (CLDQ-I). With the aim of evaluating possible changes in the QOL items addressed, the questionnaire was administered to patients at the time of telephone contact with the specific request to recall their QOL perceptions during two different time points. In detail, patients were asked to recall these perceptions first during time 0 (t0), a period comprising the 2 wk preceding the date of ministerial lockdown decree (from February 23 to March 7, 2020); then, in the course of the same phone call, they were asked to recall the same items as experienced throughout time 1 (t1), the second predetermined time frame encompassing the 2 wk (from April 6 to April 19) preceding our telephone contact and questionnaire administration. All data are expressed as number (%), and continuous variables are reported as the median (interquartile range). The data were compared using the Wilcoxon paired non-parametric test. RESULTS A total of 111 patients were enrolled, of whom 81 completed the questionnaire. Forty-nine had liver cirrhosis, and all of them had compensated disease; 32 patients had autoimmune liver disease. The majority (93.8%) of patients were aware of COVID-19 transmission modalities and on how to recognize the most common alarm symptoms (93.8%). Five of 32 (15.6%) patients with autoimmune liver disease reported having had the need to receive more information about the way to manage their liver disease therapy during lockdown and nine (28.2%) thought about modifying their therapy without consulting their liver disease specialist. About the impact on QOL, all CLDQ-I total scores were significantly worsened during time t1 as compared to time t0. CONCLUSION The COVID-19 epidemic has had a significant impact on the QOL of our population of patients, despite a good knowledge of preventive measure and means of virus transmission.

Mental Health and Quality of Life in Patients with Chronic Liver Disease: A Single-Center Structural Equation Model

“…Some studies also highlight that low quality of life is associated with the stage of disease or number of symptoms, the level of liver function, and the extent of social support in patients [32]. In the aftermath of the COVID-19 pandemic, CLD patients have known to suffer a greater decline in quality of life due to a lack of clarity about how to manage their disease during the lockdown and how to deal with infection and vaccination protocols [33]. The theoretical model for this study which is based on the previously described literature is summarized in Fig.…”

Health-Related Quality of Life of Tuberculosis Patients during the COVID-19 Pandemic in Conakry, Guinea: A Mixed Methods Study

“…HRQoL may be influenced by the clinical evolution of TB, with an impaired mental well-being being associated with the early months of treatment [15]. Additionally, emerging evidence has documented the negative impacts of the overall HRQoL during the COVID-19 pandemic, particularly among the elderly [16], people who were infected by COVID-19 [17], and those with pre-existing medical conditions [18,19].…”

Health-Related Quality of Life of Tuberculosis Patients During the COVID-19 Pandemic in Conakry, Guinea: A Mixed Methods Study

“…HRQoL may be influenced by the clinical evolution of the TB, with an impaired mental well-being has been associated with an early month of treatment [14]. Additionally, emerging evidence has documented the negative impacts of the overall HRQoL during the COVID-19 pandemic, particularly among the elderly [15], people who were infected by COVID-19 [16], and those with pre-existing medical conditions [17,18].…”