FUNCTIONAL AND PSYCHOSOCIAL OUTCOMES ON PATIENTS WITH MODERATE-TO-SEVERE COVID-19 DISEASES: A POST-HOSPITALIZATION FOLLOW-UP STUDY

• DOI: 10.1016/j.ijid.2023.04.371
• Publication Date: 2023-05-17T04:31:17Z
• Authors: C.P. Hor; L.K. Teo; H.X. Wang; Y.J. Teoh; T.L. Chong; C.H. Yen; N. Abdul Mutalib; J.T. Cheng
• Keywords: 0303 health sciences; 03 medical and health sciences; Infectious and parasitic diseases; RC109-216; Article

INTRO: COVID-19 survivors suffer from variable limitations affecting their quality of life. We examined the functional and psychosocial outcomes among COVID-19 patients with moderate-to-severe diseases by three months post-hospitalization. METHODS: This retrospective cohort study included 510 COVID-19 patients admitted to Kepala Batas Hospital with moderate-to-severe diseases, requiring oxygen therapy during hospitalization (Malaysia COVID-19 severity category ≥5; WHO scale ≥5), between January and August 2021. We followed up with telephone surveillances by 90 days post-discharge from the hospital, assessing their performance in activities of daily living and psychosocial implications. Relevant clinical data were extracted from medical records. We compared patients with low (<10L/ min) versus higher (≥10L/min) oxygen requirements on the patient-reported outcome variables. FINDINGS: Among 441 survivors (86.5%), half (n=223, 50.6%) were male, with a relatively young population with a mean age of 50.2 (13.73) years. Only 17.9% were partially vaccinated and 5.7% had complete vaccination before hospitalization. Nearly 70% were supplemented with nasal prong or face mask oxygenation (<10L/ min), 26.1% received high flow oxygenation and 4.1% were mechanically ventilated. By 90-day follow-up, >90% had their functionality returned to baseline before hospitalization. Only 1.6% required home oxygen supplementation. Compared with their baseline functionality, 4.8% were unable to perform basic household chores, 4.1% required assistance in mobilization and 2.5% became fully dependent on caretakers. Among 254 patients returning to work, 98% worked in the same institution but 18.9% required job scope adjustments. About 7.7% experienced post-covid stigma at home and/or work, 3,9% suffered from depression 5.7% became self-isolated and 0.9% had suicidal ideation or attempts. Functional and psychosocial outcomes were similar between patients with low and higher oxygen requirements (all p>0.05). CONCLUSION: Despite fair recovery outcomes reported by survivors with moderate-to-severe disease, a small proportion suffered from significant functional limitations and psychosocial adversity. Post-hospitalization care is essential to screen-detect post-COVID complications and provide timely interventions.