慢性心力衰竭患者在 COVID-19 期间和之后的生活质量:使用 EuroQoL 视觉模拟量表的观察研究

Emoke Ilona Sukosd, N. Kundnani, Hasan Elisei Moise, M. Stelian, Olivia-Maria Bodea, Andor Minodoara
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EuroQoL questionnaires responses were recorded at 3 time-points (Q1 before COVID-19 infection, Q2 during an acute episode of COVID-19, and Q3 at 6 months after COVID infection). The statistical analysis was carried out both in a cross-sectional view for each time-point and longitudinally. The non-parametric Mann-Whitney test for independent series was applied in the case of subgroup comparison, and the Wilcoxon signed ranks test was used in the longitudinal study. Results Based on the responses given by the patients, there was decline in QoL noted in all patients, mainly in females, included in our study during the acute phase of the infection, as compared to their pre-COVID-19 admission for a follow-up for their heart disease (Q1: 78.89 vs Q2: 66.11 in males and Q1: 71.54 vs Q2: 49.6 in females, p=0.015 for Q2). Improvement was noted in the evaluation done after 6 months to the acute episode, although the values failed to attain to that of the initial pre-COVID-19 analysis, with Q3: 71.92 in males and 70.56 in females. Conclusions Understanding these implications can guide healthcare interventions for better management and support, particularly in the context of pre-existing chronic conditions exacerbated by acute infections like COVID-19. The results may prompt further research into the long-term effects of COVID-19 on individuals with chronic diseases, guiding future studies to explore specific interventions or preventive measures. QoL during the acute phase of COVID-19 infection is affected on a larger extent as compared to previous analysis in chronic heart failure patients. Larger studies with a longer time span can indicate the time duration required for CHF patients to attain the pre-COVID-19 QoL status. 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引用次数: 0

摘要

背景 慢性病会影响患者的身心健康。急性感染会使病情进一步恶化。冠状病毒引起的多器官损伤和急性呼吸窘迫会导致原本稳定的慢性疾病恶化。材料/方法 我们的研究旨在比较慢性心力衰竭(CHF)患者在感染 COVID-19 前和感染后的生活质量,其依据是对 EuroQoL 视觉模拟量表(EQ VAS)的反应。研究对象包括患有慢性心力衰竭并感染 COVID-19 的患者。在三个时间点(COVID-19 感染前的第一季度、COVID-19 急性发作期的第二季度和 COVID 感染后 6 个月的第三季度)记录了 EuroQoL 问卷的回答。统计分析在每个时间点横向和纵向进行。亚组比较采用非参数曼-惠特尼独立序列检验,纵向研究采用 Wilcoxon 符号秩检验。结果 根据患者的回答,我们研究的所有患者(主要是女性)在感染急性期的 QoL 都有所下降,与他们入院接受 COVID-19 前的心脏病随访相比(男性 Q1:78.89 vs Q2:66.11,女性 Q1:71.54 vs Q2:49.6,Q2 的 p=0.015)。急性发作 6 个月后进行的评估显示,情况有所改善,但数值仍未达到 COVID-19 分析前的初始值,男性 Q3:71.92,女性 Q3:70.56。结论 了解这些影响可以指导医疗保健干预措施,以便更好地管理和支持,尤其是在原有慢性病因 COVID-19 等急性感染而加重的情况下。这些结果可能会促使人们进一步研究 COVID-19 对慢性病患者的长期影响,从而指导未来的研究探索具体的干预或预防措施。与以往对慢性心力衰竭患者的分析相比,COVID-19 感染急性期的 QoL 受影响程度更大。时间跨度更长的大型研究可以说明慢性心力衰竭患者达到 COVID-19 感染前 QoL 状态所需的时间。开发提高 QoL 评估准确性的方法可以进一步减少所看到的偏差,尤其是对以前不健康的受试者。这项研究的结果可以让医疗服务提供者了解慢性心力衰竭患者在感染 COVID-19 期间和之后面临的更高风险和特殊挑战。政策制定者可以利用这些发现制定有针对性的公共卫生政策,在传染病爆发期间和之后保护和支持慢性病患者,确保采取全面的医疗保健策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Quality of Life of Chronic Heart Failure Patients During and After COVID-19: Observational Study Using EuroQoL-Visual Analogue Scales
Background Chronic diseases affect both the mental and physical health of patients. An acute infection can further deteriorate it. The multi-organ damage and acute respiratory distress caused by coronavirus leads to worsening of the previously stable state of chronic diseases. Material/Methods The aim of our study was to compare the quality of life during pre-acute-post-COVID-19 infection status of chronic heart failure (CHF) patients based on responses on the EuroQoL-visual analogue scales (EQ VAS). Patients suffering from CHF and a COVID-19 infection were included in our study. EuroQoL questionnaires responses were recorded at 3 time-points (Q1 before COVID-19 infection, Q2 during an acute episode of COVID-19, and Q3 at 6 months after COVID infection). The statistical analysis was carried out both in a cross-sectional view for each time-point and longitudinally. The non-parametric Mann-Whitney test for independent series was applied in the case of subgroup comparison, and the Wilcoxon signed ranks test was used in the longitudinal study. Results Based on the responses given by the patients, there was decline in QoL noted in all patients, mainly in females, included in our study during the acute phase of the infection, as compared to their pre-COVID-19 admission for a follow-up for their heart disease (Q1: 78.89 vs Q2: 66.11 in males and Q1: 71.54 vs Q2: 49.6 in females, p=0.015 for Q2). Improvement was noted in the evaluation done after 6 months to the acute episode, although the values failed to attain to that of the initial pre-COVID-19 analysis, with Q3: 71.92 in males and 70.56 in females. Conclusions Understanding these implications can guide healthcare interventions for better management and support, particularly in the context of pre-existing chronic conditions exacerbated by acute infections like COVID-19. The results may prompt further research into the long-term effects of COVID-19 on individuals with chronic diseases, guiding future studies to explore specific interventions or preventive measures. QoL during the acute phase of COVID-19 infection is affected on a larger extent as compared to previous analysis in chronic heart failure patients. Larger studies with a longer time span can indicate the time duration required for CHF patients to attain the pre-COVID-19 QoL status. Developing methods to increase the accuracy of QoL evaluation can further reduce the bias witnessed, especially in previously unhealthy subjects. The study’s findings could inform healthcare providers about the heightened risk and specific challenges faced by chronic heart failure patients during and after a COVID-19 infection. Policymakers can use these findings to develop targeted public health policies aimed at protecting and supporting individuals with chronic conditions during and after infectious outbreaks, ensuring comprehensive healthcare strategies.
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