Patient-reported outcome measures after COVID-19: a prospective cohort study

Wong, Alyson W.; Shah, Aditi; Johnston, James C.; Carlsten, Christopher; Ryerson, Christopher J.

doi:10.1183/13993003.03276-2020

Cited by 182 publications

(272 citation statements)

References 14 publications

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“…At 2 months follow-up, half of the patients reported persistent fatigue, whereas dyspnea (43%) and chest pain (22%) were also highly prevalent. These findings are in line with the studies by Wong et al (2020) and Garrigues et al (2020) , both of which found nearly half of the patients complaining of breathlessness at 3 months after hospital discharge.…”

Section: Persisting Cariorespiratory Symptoms In Coronavirus Survivorsupporting

confidence: 91%

Hyperventilation: A Possible Explanation for Long-Lasting Exercise Intolerance in Mild COVID-19 Survivors?

et al. 2021

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Since the outbreak of the coronavirus (COVID-19) pandemic, most attention has focused on containing transmission and addressing the surge of critically ill patients in acute care settings. As we enter the second phase of the pandemic, emphasis must evolve to post-acute care of COVID-19 survivors. Persisting cardiorespiratory symptoms have been reported at several months after the onset of the infection. Information is lacking on the pathophysiology of exercise intolerance after COVID-19. Previous outbreaks of coronaviruses have been associated with persistent dyspnea, muscle weakness, fatigue and reduced quality of life. The extent of Covid-19 sequelae remains to be evaluated, but persisting cardiorespiratory symptoms in COVID-19 survivors can be described as two distinct entities. The first type of post-Covid symptoms are directly related to organ injury in the acute phase, or the complications of treatment. The second type of persisting symptoms can affect patients even with mild initial disease presentation without evidence of organ damage. The mechanisms are still poorly qualified to date. There is a lack of correlation between initial symptom severity and residual symptoms at exertion. We report exercise hyperventilation as a major limiting factor in COVID-19 survivors. The origin of this hyperventilation may be related to an abnormality of ventilatory control, by either hyperactivity of activator systems (automatic and cortical ventilatory control, peripheral afferents, and sensory cortex) or failure of inhibitory systems (endorphins) in the aftermath of pulmonary infection. Hyperventilation-induced hypocapnia can cause a multitude of extremely disabling symptoms such as dyspnea, tachycardia, chest pain, fatigue, dizziness and syncope at exertion.

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Section: Persisting Cariorespiratory Symptoms In Coronavirus Survivorsupporting

confidence: 91%

Hyperventilation: A Possible Explanation for Long-Lasting Exercise Intolerance in Mild COVID-19 Survivors?

et al. 2021

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“…Little is known about long-term recovery from COVID-19 disease and studies about quality of life in these patients are lacking. A study by Wong and colleagues (2020) showed that over half of previously hospitalized COVID-19 survivors had a lower quality of life (measured with EQ-5D) three months after symptom onset compared to age-matched norms of the Canadian population [7]. Our non-hospitalized population showed similar results, with 40% of the patients reporting a generic quality of life below the fifth percentile of reference values.…”

Section: Discussionsupporting

confidence: 56%

“…Nevertheless, the consequences of viral infections remain poorly understood and the impact of COVID-19 on quality of life in patients who have not been admitted to the hospital may be highly underestimated. To date, only a few studies, focused on hospitalized patients, demonstrated a negative impact of (suspected) COVID-19 symptoms on generic quality of life [ 6 , 7 ]. Quality of life can be assessed using generic (i.e., intended for general use, irrespective of the underlying disease) or disease-specific health status questionnaires (i.e., related to a specific condition or group).…”

Section: Introductionmentioning

confidence: 99%

Generic and Respiratory-Specific Quality of Life in Non-Hospitalized Patients with COVID-19

Meys

Delbressine

Goërtz

et al. 2020

JCM

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The impact of coronavirus disease 2019 (COVID-19) on quality of life appears to be highly underestimated, especially in patients who have not been admitted to the hospital. Therefore, our aim was to assess respiratory-specific quality of life in addition to generic quality of life in former patients with confirmed/suspected COVID-19 who have never been admitted to the hospital. Members of an online Belgian social support group for patients with confirmed/suspected COVID-19 with persistent complaints, completed an online survey. The five-level EQ-5D (EQ-5D-5L) and the Clinical COPD Questionnaire (CCQ) were used to assess generic and respiratory-specific quality of life, respectively. Data of 210 non-hospitalized patients (88% women, 45 ± 11 years, 79 ± 17 days after symptom onset) were included in the analyses. Mean EQ-5D index and visual analogue scale (EQ-VAS) score was 0.62 ± 0.19 and 50.71 ± 18.87, respectively, with 40% of the patients demonstrating an EQ-5D index that was below the fifth percentile of normative values, indicating poor generic quality of life. The mean CCQ score was 2.01 ± 0.98 points, while 123 respondents (59%) had a total score ≥1.9 points, indicating poor respiratory-specific quality of life. The correlation between EQ-5D index score/EQ-VAS score and CCQ total score was moderate (r = −0.524 and r = −0.374; both p < 0.001). In conclusion, both generic and respiratory-specific quality of life are affected in non-hospitalized patients with COVID-19, approximately three months after the onset of symptoms. The combined use of the EQ-5D and the CCQ could identify the broad impact of COVID-19 on quality of life.

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“…However, these complications appear to be disturbingly common 17 and thus may further diminish work capacity. As the pandemic progresses, there is concern for lingering or even chronic symptoms beyond the respiratory system and with major quality of life implications, based on recent data 18 . Lessons drawn from previous and current pandemics and disasters must be learned, and inform future responses to these inevitable events.…”

Section: Introductionmentioning

confidence: 99%

COVID‐19 as an occupational disease

Carlsten

Gulati

Hines

et al. 2021

American J Industrial Med

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115

155

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The impact of coronavirus disease 2019 (COVID‐19) caused by the severe acute respiratory syndrome coronavirus 2 permeates all aspects of society worldwide. Initial medical reports and media coverage have increased awareness of the risk imposed on healthcare workers in particular, during this pandemic. However, the health implications of COVID‐19 for the global workforce are multifaceted and complex, warranting careful reflection and consideration to mitigate the adverse effects on workers worldwide. Accordingly, our review offers a framework for considering this topic, highlighting key issues, with the aim to prompt and inform action, including research, to minimize the occupational hazards imposed by this ongoing challenge. We address respiratory disease as a primary concern, while recognizing the multisystem spectrum of COVID‐19‐related disease and how clinical aspects are interwoven with broader socioeconomic forces.

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Patient-reported outcome measures after COVID-19: a prospective cohort study

Abstract: Take-home message: Over 75% of patients admitted to hospital with COVID-19 have abnormal patient-reported outcome measures 3 months after symptom onset, with a third of patients reporting at least moderate impairment in major dimensions of quality of life.

Cited by 182 publications

References 14 publications

Hyperventilation: A Possible Explanation for Long-Lasting Exercise Intolerance in Mild COVID-19 Survivors?

Hyperventilation: A Possible Explanation for Long-Lasting Exercise Intolerance in Mild COVID-19 Survivors?

Generic and Respiratory-Specific Quality of Life in Non-Hospitalized Patients with COVID-19

COVID‐19 as an occupational disease

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