People who had severe forms of Covid-19, requiring hospitalization, were at greater risk of developing cardiovascular problems, in addition to impacts on mental health and long-term disabilities.
The data is from a new study published in the scientific journal Intensive Care Medicine, of the European Society of Intensive Medicine. To arrive at the result, researchers followed patients who were discharged after hospitalization for Covid-19 in Brazilian institutions for a period of one year.
Specialists identified that the more severe conditions of the disease during hospitalization, defined by the need for mechanical ventilation, for example, were associated with significant impacts on quality of life and worse results in mortality outcomes, with major cardiovascular events, new hospitalizations, symptoms of anxiety and post-traumatic stress, in addition to inability to carry out daily activities and difficulties in returning to work or school.
One of the main findings is the high percentage of patients who reported new disabilities, such as difficulty getting around, taking care of their own hygiene, shopping and managing their finances. Among those who required mechanical ventilation, this rate was 47%.
The study identified that one in four people intubated during treatment needed to be rehospitalized over the subsequent 12 months. In addition, 5.6% had a heart attack, cerebrovascular accident (CVA) or died from cardiovascular disease, twice the rate among patients who did not require respiratory support during hospitalization.
The researchers followed 1,508 patients admitted to 84 hospitals in Brazil. Volunteers were classified into four groups: those who did not need oxygen support; those who received oxygenation through a mask or nasal cannula; those requiring non-invasive ventilation or oxygen through a high-flow nasal catheter; and those who were intubated and required mechanical ventilation.
Contacts for monitoring quality of life, persistent symptoms, health complications and other illnesses were carried out through telephone interviews at three, six, nine and 12 months after discharge.
The study was conducted by Coalizão Covid-19 Brasil, an alliance formed by Hospital Israelita Albert Einstein, Hcor, Hospital SÃrio-Libanês, Hospital Moinhos de Vento, Hospital Alemão Oswaldo Cruz, BP – A Beneficência Portuguesa de São Paulo, the Brazilian Clinical Research Institute (BCRI) and the Brazilian Network for Research in Intensive Care (BRICNet).
The post-discharge mortality rate in patients intubated during treatment was 8% over the 12 months, while among those who did not require ventilatory support it was 2%.
According to the researchers, mechanical ventilation is an important marker of disease severity and indicates a greater degree of lung impairment and other organs. The technique, which is not associated with damage, is an indication that that individual may need priority treatment in rehabilitation.
The survey also warns of the need for tracking post-discharge patients, due to deaths due to complications of the disease after hospitalization.
The impacts on mental health are also of concern to researchers. The prevalence of post-traumatic stress disorder (PTSD) in patients who used mechanical ventilation was twice that of the Brazilian population in general.
In addition, one in four experienced symptoms of anxiety. The researchers point out that this mental health impairment, added to the reported physical disabilities, is associated with a significant reduction in quality of life.
Source: CNN Brasil
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