Changes in Quality of Life and Dyspnoea After Hospitalization in COVID-19 Patients Discharged at Home

Overview

Journal Multidiscip Respir Med

Specialty Pulmonary Medicine

Date 2020 Oct 29

PMID 33117535

Citations 27

Authors

Pierachille Santus

Francesco Tursi

Giuseppe Croce

Chiara Di Simone

Francesca Frassanito

Paolo Gaboardi

Andrea Airoldi

Marica Pecis

Giangiuseppe Negretto

Dejan Radovanovic

Affiliations

Soon will be listed here.

Abstract

Background: To date, the effects of COVID-19 pneumonia on health-related quality of life (HRQoL) and dyspnoea are unknown.

Methods: In a 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. At discharge (T0) and on Day 15 (T1), participants completed the St George's Respiratory Questionnaire (SGRQ), 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. Paired t-tests compared scores at T0 and T1.

Results: The mean (SD) SGRQ total score decreased from 25.5 (15.5) at T0 to 16.9 (13.2) at T1 (p<0.01); 65% of patients achieved a clinically important change of ≥4 points. SGRQ domain scores (symptoms, activity, and impact) were also significantly reduced (all p<0.01). The mean (SD) VAS score decreased from 1.6 (1.7) to 1.4 (2.5); p<0.01. The mean mMRC score decreased significantly (p=0.031) and 30% of patients achieved a clinically important change of ≥1 point. The mean (SD) Borg score increased from 12.8 (4.2) to 14.3 (2.4); p<0.01.

Conclusion: The present proof of concept study is the first to report HRQoL in patients with COVID-19. During 15 days after hospital discharge, patients reported significant improvements in HRQoL and dyspnoea at rest and during daily activities.

Citing Articles

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References

Davidson T, Caldwell E, Curtis J, Hudson L, Steinberg K . Reduced quality of life in survivors of acute respiratory distress syndrome compared with critically ill control patients. JAMA. 1999; 281(4):354-60. DOI: 10.1001/jama.281.4.354. View

Radovanovic D, Rizzi M, Pini S, Saad M, Chiumello D, Santus P . Helmet CPAP to Treat Acute Hypoxemic Respiratory Failure in Patients with COVID-19: A Management Strategy Proposal. J Clin Med. 2020; 9(4). PMC: 7230457. DOI: 10.3390/jcm9041191. View

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z . Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020; 395(10229):1054-1062. PMC: 7270627. DOI: 10.1016/S0140-6736(20)30566-3. View

Wang D, Yin Y, Hu C, Liu X, Zhang X, Zhou S . Clinical course and outcome of 107 patients infected with the novel coronavirus, SARS-CoV-2, discharged from two hospitals in Wuhan, China. Crit Care. 2020; 24(1):188. PMC: 7192564. DOI: 10.1186/s13054-020-02895-6. View

Ye G, Pan Z, Pan Y, Deng Q, Chen L, Li J . Clinical characteristics of severe acute respiratory syndrome coronavirus 2 reactivation. J Infect. 2020; 80(5):e14-e17. PMC: 7102560. DOI: 10.1016/j.jinf.2020.03.001. View

Ahmed H, Patel K, Greenwood D, Halpin S, Lewthwaite P, Salawu A . Long-term clinical outcomes in survivors of severe acute respiratory syndrome and Middle East respiratory syndrome coronavirus outbreaks after hospitalisation or ICU admission: A systematic review and meta-analysis. J Rehabil Med. 2020; 52(5):jrm00063. DOI: 10.2340/16501977-2694. View

Jones P . St. George's Respiratory Questionnaire: MCID. COPD. 2006; 2(1):75-9. DOI: 10.1081/copd-200050513. View

Vitacca M, Lazzeri M, Guffanti E, Frigerio P, DAbrosca F, Gianola S . Italian suggestions for pulmonary rehabilitation in COVID-19 patients recovering from acute respiratory failure: results of a Delphi process. Monaldi Arch Chest Dis. 2020; 90(2). DOI: 10.4081/monaldi.2020.1444. View

Hsieh M, Lee W, Cho H, Wu M, Hu H, Kao K . Recovery of pulmonary functions, exercise capacity, and quality of life after pulmonary rehabilitation in survivors of ARDS due to severe influenza A (H1N1) pneumonitis. Influenza Other Respir Viruses. 2018; 12(5):643-648. PMC: 6086854. DOI: 10.1111/irv.12566. View

10.

Ferrer M, Villasante C, Alonso J, Sobradillo V, Gabriel R, Vilagut G . Interpretation of quality of life scores from the St George's Respiratory Questionnaire. Eur Respir J. 2002; 19(3):405-13. DOI: 10.1183/09031936.02.00213202. View

11.

Ong K, Ng A, Lee L, Kaw G, Kwek S, Leow M . 1-year pulmonary function and health status in survivors of severe acute respiratory syndrome. Chest. 2005; 128(3):1393-400. PMC: 7094739. DOI: 10.1378/chest.128.3.1393. View

12.

Zheng Z, Yao Z, Wu K, Zheng J . Patient follow-up after discharge after COVID-19 pneumonia: Considerations for infectious control. J Med Virol. 2020; 92(11):2412-2419. PMC: 7267672. DOI: 10.1002/jmv.25994. View

13.

Bassetti M, Giacobbe D, Aliberti S, Barisione E, Centanni S, De Rosa F . Balancing evidence and frontline experience in the early phases of the COVID-19 pandemic: current position of the Italian Society of Anti-infective Therapy (SITA) and the Italian Society of Pulmonology (SIP). Clin Microbiol Infect. 2020; 26(7):880-894. PMC: 7195088. DOI: 10.1016/j.cmi.2020.04.031. View

14.

Crisafulli E, Clini E . Measures of dyspnea in pulmonary rehabilitation. Multidiscip Respir Med. 2012; 5(3):202-10. PMC: 3463047. DOI: 10.1186/2049-6958-5-3-202. View

15.

Polonikov A . Endogenous Deficiency of Glutathione as the Most Likely Cause of Serious Manifestations and Death in COVID-19 Patients. ACS Infect Dis. 2020; 6(7):1558-1562. DOI: 10.1021/acsinfecdis.0c00288. View

16.

Mo X, Jian W, Su Z, Chen M, Peng H, Peng P . Abnormal pulmonary function in COVID-19 patients at time of hospital discharge. Eur Respir J. 2020; 55(6). PMC: 7236826. DOI: 10.1183/13993003.01217-2020. View

17.

Dowdy D, Eid M, Dennison C, Mendez-Tellez P, Herridge M, Guallar E . Quality of life after acute respiratory distress syndrome: a meta-analysis. Intensive Care Med. 2006; 32(8):1115-24. DOI: 10.1007/s00134-006-0217-3. View

18.

Tansey C, Louie M, Loeb M, Gold W, Muller M, de Jager J . One-year outcomes and health care utilization in survivors of severe acute respiratory syndrome. Arch Intern Med. 2007; 167(12):1312-20. DOI: 10.1001/archinte.167.12.1312. View

19.

Bestall J, Paul E, Garrod R, Garnham R, Jones P, Wedzicha J . Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax. 1999; 54(7):581-6. PMC: 1745516. DOI: 10.1136/thx.54.7.581. View

20.

Silvagno F, Vernone A, Pescarmona G . The Role of Glutathione in Protecting against the Severe Inflammatory Response Triggered by COVID-19. Antioxidants (Basel). 2020; 9(7). PMC: 7402141. DOI: 10.3390/antiox9070624. View