Quality of Life after Coronavirus Disease 2019 Hospitalization and Rehabilitation Needs

Authors

  • Nikolaos Kintrilis Infectious Disease Unit, 401 General Military Hospital of Athens, Athens
  • Antonis Kontaxakis Physical and Rehabilitation Medicine Department, 414 Military Hospital of Special Diseases, Penteli
  • Athanasia Papalambidou Physical and Rehabilitation Medicine Department, 414 Military Hospital of Special Diseases, Penteli
  • Prokopios Manthos Physical and Rehabilitation Medicine Department, General Hospital of Athens, “Gennimatas”, Athens
  • Zaira Simeonidou Physical and Rehabilitation Medicine Department, 414 Military Hospital of Special Diseases, Penteli
  • Aggeliki Stavrianou Physical and Rehabilitation Medicine Center, General Hospital of Florina “Elena Dimitriou”, Florina, Greece
  • Eleni Moumtzi-Nakka Physical and Rehabilitation Medicine Department, 414 Military Hospital of Special Diseases, Penteli
  • Iosif Galinos Infectious Disease Unit, 401 General Military Hospital of Athens, Athens
  • Christina Anastasia Rapidi Physical and Rehabilitation Medicine Department, General Hospital of Athens, “Gennimatas”, Athens

DOI:

https://doi.org/10.2340/jrmcc.v6.5327

Keywords:

SARS-CoV-2, COVID-19, hospitalization, quality of life, post COVID-19 condition, rehabilitation

Abstract

Introduction: During the current pandemic, there has been a paucity of Greek data in terms of recording the general long-term functional status of patients after coronavirus disease 2019 (COVID-19) hospitalizations, as well as very little information regarding rehabilitation services nationwide and their utilization.
Objective-design: This is a prospective cohort study, including 92 adults discharged from the Infectious Disease Unit of a third-level hospital in Greece after hospitalization with COVID-19. Demographics and disease severity data was collected upon admission and symptoms at discharge, 4 months and 1 year. Following rating of 12 common symptoms on a Likert scale, quality-of-life data and accessibility to rehabilitation services were compared among the 3 time points.
Results: At discharge, the most prevalent complaints were fatigue, exertional dyspnoea and difficulty walking. At 4 months, these 3 remained among the most prevalent symptoms, while pain and memory/loss concentration remained at high numbers as well. Finally, at the 1-year mark, the percentages of patients reporting fatigue, exertional dyspnoea and pain were the highest. At the 4-month follow-up, only 4.3% of the study participants had visited a rehabilitation facility of any kind, whereas at the 1-year mark the percentage rose to 10.9%.
Conclusion: A clinically relevant number of participants experienced at least one post-COVID-19 hospitalization symptom. Quality of life was markedly affected by the longer-term effects of the disease. The percentage of people finally attending any kind of rehabilitation service was poor. With thousands more being infected and needing hospitalization nationwide daily, the need for the inclusion of relevant rehabilitation programmes in the Greek healthcare system appears imminent.

LAY ABSTRACT
For this research paper, we studied 92 adults discharged from the Infectious Disease Unit of a third-level hospital after hospitalization with COVID-19, examining their quality of life and accessibility to rehabilitation services among 3 time points: discharge, 4 months and 1 year afterwards. At discharge, the most prevalent complaints were fatigue, exertional dyspnoea and difficulty walking. At 4 months, these 3 remained among the most prevalent symptoms, while pain and memory/loss concentration remained at high numbers as well. Finally, at the 1-year mark, the percentages of patients reporting fatigue, exertional dyspnoea and pain were the highest. Quality of life was markedly affected by the longer-term effects of the disease. The percentage of people finally attending any kind of rehabilitation service was poor. Without a doubt, the need for inclusion of rehabilitation programmes in the healthcare systems is imminent in order to face the continued pandemic challenge.

Downloads

Download data is not yet available.

References

Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020; 382(8): 727–733. https://doi.org/10.1056/nejmoa2001017 DOI: https://doi.org/10.1056/NEJMoa2001017

Coronavirus disease (COVID-19) situation reports [Internet]. Who.int [cited 2022 Nov 23]. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports

Greenhalgh T, Knight M, A’Court C, Buxton M, Husain L. Management of post-acute covid-19 in primary care. BMJ 2020; 370: m3026. https://doi.org/10.1136/bmj.m3026 DOI: https://doi.org/10.1136/bmj.m3026

Demeco A, Marotta N, Barletta M, Pino I, Marinaro C, Petraroli A, et al. Rehabilitation of patients post-COVID-19 infection: a literature review. J Int Med Res 2020; 48(8): 030006052094838. https://doi.org/10.1177/0300060520948382 DOI: https://doi.org/10.1177/0300060520948382

Huang C, Huang L, Wang Y, Li X, Ren L, Gu X, et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet 2021; 397(10270): 220–232. https://doi.org/10.1016/s0140-6736(20)32656-8 DOI: https://doi.org/10.1016/S0140-6736(20)32656-8

Logue JK, Franko NM, McCulloch DJ, McDonald D, Magedson A, Wolf CR, et al. Sequelae in adults at 6 months after COVID-19 infection. JAMA Netw Open 2021; 4(2): e210830. https://doi.org/10.1001/jamanetworkopen.2021.0830 DOI: https://doi.org/10.1001/jamanetworkopen.2021.0830

Han Q, Zheng B, Daines L, Sheikh A. Long-term sequelae of COVID-19: a systematic review and meta-analysis of one-year follow-up studies on post-COVID symptoms. Pathogens 2022; 11(2): 269. https://doi.org/10.3390/pathogens11020269 DOI: https://doi.org/10.3390/pathogens11020269

Agostini F, Mangone M, Ruiu P, Paolucci T, Santilli V, Bernetti A. Rehabilitation setting during and after Covid-19: an overview on recommendations. J Rehabil Med 2021; 53(1): jrm00141. https://doi.org/10.2340/16501977-2776 DOI: https://doi.org/10.2340/16501977-2776

Greece [Internet]. Who.int. [cited 2022 Nov 23]. Available from: https://www.who.int/countries/grc

Giannopoulou I, Tsobanoglou GO. COVID-19 pandemic: challenges and opportunities for the Greek health care system. Irish J Psychol Med 2020; 37(3): 226–230. https://doi.org/10.1017/ipm.2020.35 DOI: https://doi.org/10.1017/ipm.2020.35

Dimitriadis V, Kousoulis AA, Markaki A, Sgantzos MN, Hadjipavlou A, Lionis C. Quality assessment systems in rehabilitation services for people with a disability in Greece: a critical review. Disabil Health J 2013; 6(3): 157–164. https://doi.org/10.1016/j.dhjo.2013.01.005 DOI: https://doi.org/10.1016/j.dhjo.2013.01.005

Herdman M, Gudex C, Lloyd A, Janssen MF, Kind P, Parkin D, et al. Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res 2011; 20(10): 1727–1736. https://doi.org/10.1007/s11136-011-9903-x DOI: https://doi.org/10.1007/s11136-011-9903-x

Chen C, Haupert SR, Zimmermann L, Shi X, Fritsche LG, Mukherjee B. Global prevalence of post-Coronavirus disease 2019 (COVID-19) condition or long COVID: a meta-analysis and systematic review. J Infect Dis 2022; 226(9): 1593–1607. https://doi.org/10.1093/infdis/jiac136 DOI: https://doi.org/10.1093/infdis/jiac136

Davis HE, Assaf GS, McCorkell L, Wei H, Low RJ, Re’em Y, et al. Characterizing long COVID in an international cohort: 7 months of symptoms and their impact. EClinicalMedicine 2021; 38(101019): 101019. https://doi.org/10.1016/j.eclinm.2021.101019 DOI: https://doi.org/10.1016/j.eclinm.2021.101019

Koc HC, Xiao J, Liu W, Li Y, Chen G. Long COVID and its management. Int J Biol Sci 2022; 18(12): 4768–4780. https://doi.org/10.7150/ijbs.75056 DOI: https://doi.org/10.7150/ijbs.75056

Nurek M, Rayner C, Freyer A, Taylor S, Järte L, MacDermott N, et al. Recommendations for the recognition, diagnosis, and management of long COVID: a Delphi study. Br J Gen Pract 2021; 71(712): e815–e825. https://doi.org/10.3399/BJGP.2021.0265 DOI: https://doi.org/10.3399/BJGP.2021.0265

Negrini S, Borg K, Cusick A, Ferriero G, Frontera WR, Gross DP, et al. Global statements to produce and implement evidence in the post-COVID-era provide a path forward for rehabilitation – A joint initiative of Cochrane Rehabilitation and the leading journals in the field. J Rehabil Med 2022; 54: jrm00345. https://doi.org/10.2340/jrm.v54.4858 DOI: https://doi.org/10.2340/jrm.v54.4858

Wang TJ, Chau B, Lui M, Lam G-T, Lin N, Humbert S. Physical medicine and rehabilitation and pulmonary rehabilitation for COVID-19. Am J Phys Med Rehabil 2020; 99(9): 769–774. https://doi.org/10.1097/phm.0000000000001505 DOI: https://doi.org/10.1097/PHM.0000000000001505

Barker-Davies RM, O’Sullivan O, Senaratne KPP, Baker P, Cranley M, Dharm-Datta S, et al. The Stanford Hall consensus statement for post-COVID-19 rehabilitation. Br J Sports Med 2020; 54(16): 949–959. https://doi.org/10.1136/bjsports-2020-102596 DOI: https://doi.org/10.1136/bjsports-2020-102596

Hentschel CB, Abramoff BA, Dillingham TR, Pezzin LE. Race, ethnicity, and utilization of outpatient rehabilitation for treatment of post COVID-19 condition. PM&R 2022; 14(11): 1315–1324. https://doi.org/10.1002/pmrj.12869 DOI: https://doi.org/10.1002/pmrj.12869

Benavides-Cordoba V, Barros-Poblete M, Vieira RP, Mazzucco G, Fregonezi G, Torres-Castro R. Provision of pulmonary rehabilitation in Latin America 18 months after the COVID-19 pandemic: a survey of the Latin American Thoracic Association. Chron Respir Dis 2022; 19: 147997312211041. https://doi.org/10.1177/14799731221104102 DOI: https://doi.org/10.1177/14799731221104102

Falvey JR, Ferrante LE. Flattening the disability curve: rehabilitation and recovery after COVID-19 infection. Heart Lung 2020; 49(5): 440–441. https://doi.org/10.1016/j.hrtlng.2020.05.001 DOI: https://doi.org/10.1016/j.hrtlng.2020.05.001

Kim SY, Daley K, Pruski AD, AlFarra T, Azola A, Gonzalez Fernandez M, et al. Implementation of a framework for telerehabilitation in clinical care across the continuum during COVID-19 and beyond. Am J Phys Med Rehabil 2022; 101(1): 53–60. https://doi.org/10.1097/phm.0000000000001904 DOI: https://doi.org/10.1097/PHM.0000000000001904

Tsirintani M. Strategic procedures and revisions for implementing telemedicine and telecare in Greece. Appl Clin Inform 2012; 03(01): 14–23. https://doi.org/10.4338/aci-2011-08-r-0048 DOI: https://doi.org/10.4338/ACI-2011-08-R-0048

Additional Files

Published

2023-01-08

How to Cite

Kintrilis, N., Kontaxakis, A. ., Papalambidou, A., Manthos, P., Simeonidou, Z., Stavrianou, A., … Rapidi, C. A. (2023). Quality of Life after Coronavirus Disease 2019 Hospitalization and Rehabilitation Needs. Journal of Rehabilitation Medicine - Clinical Communications, 6, jrmcc00091. https://doi.org/10.2340/jrmcc.v6.5327

Issue

Section

Original Report

Categories