长新冠患者的功能障碍轨迹、健康相关生活质量和社会成本：一项基于人群的纵向队列研究。

Trajectories of functional limitations, health-related quality of life and societal costs in individuals with long COVID: a population-based longitudinal cohort study.

机构信息

Department of Primary Care and Population Health, University College London, London, UK.

Royal Free Hospital, London, UK.

出版信息

BMJ Open. 2024 Nov 13;14(11):e088538. doi: 10.1136/bmjopen-2024-088538.

DOI:10.1136/bmjopen-2024-088538

PMID:39537389

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11574431/

Abstract

OBJECTIVES

To examine trajectories of functional limitations, fatigue, health-related quality of life (HRQL) and societal costs of patients referred to long COVID clinics.

DESIGN

A population-based longitudinal cohort study using real-time user data.

SETTING

35 specialised long COVID clinics in the UK.

PARTICIPANTS

4087 adults diagnosed with long COVID in primary or secondary care deemed suitable for rehabilitation and registered in the Living With Covid Recovery (LWCR) programme between 4 August 2020 and 5 August 2022.

MAIN OUTCOME MEASURES

Generalised linear mixed models were fitted to estimate trajectories of functional limitations, using the Work and Social Adjustment Scale (WSAS); scores of ≥20 indicate moderately severe limitations. Other outcomes included fatigue using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) reversed score (scores of ≥22 indicate impairment), HRQL using the EQ-5D-5L, and long COVID-related societal costs, encompassing healthcare costs and productivity losses.

RESULTS

The mean WSAS score at 6 months after registration in the LWCR was 19.1 (95% CI 18.6, 19.6), with 46% of the participants (95% CI 40.3%, 52.4%) reporting a WSAS score above 20 (moderately severe or worse impairment). The mean change in the WSAS score over the 6-month period was -0.86 (95% CI -1.32, -0.41). The mean reversed FACIT-F score at 6 months was 29.1 (95% CI 22.7, 35.5) compared with 32.0 (95% CI 31.7, 32.3) at baseline. The mean EQ-5D-5L score remained relatively constant between baseline (0.63, 95% CI 0.62, 0.64) and 6 months (0.64, 95% CI 0.59, 0.69). The monthly societal cost per patient related to long COVID at 6 months was £931, mostly driven by the costs associated with working days lost.

CONCLUSIONS

Individuals referred to long COVID clinics in the UK reported small improvements in functional limitations, fatigue, HRQL and ability to work within 6 months of registering in the LWCR programme.

摘要

目的

研究转至长期新冠诊所的患者的功能障碍、疲劳、健康相关生活质量（HRQL）和社会成本轨迹。

设计

使用实时用户数据的基于人群的纵向队列研究。

设置

英国 35 家专门的长期新冠诊所。

参与者

2020 年 8 月 4 日至 2022 年 8 月 5 日期间，在初级或二级保健中被诊断为长期新冠且被认为适合康复并在新冠康复生活（LWCR）计划中注册的 4087 名成年人。

主要观察指标

使用工作和社会调整量表（WSAS）估计功能障碍轨迹的广义线性混合模型；WSAS 评分≥20 表示中度至重度障碍。其他结果包括使用慢性疾病治疗疲劳功能性评估量表（FACIT-F）反转评分（≥22 分表示障碍）测量的疲劳，使用 EQ-5D-5L 测量的 HRQL，以及与长期新冠相关的社会成本，包括医疗保健成本和生产力损失。

结果

LWCR 注册后 6 个月时 WSAS 平均得分为 19.1（95%CI 18.6，19.6），46%的参与者（95%CI 40.3%，52.4%）报告 WSAS 评分高于 20（中度或更严重的障碍）。6 个月期间 WSAS 评分的平均变化为-0.86（95%CI -1.32，-0.41）。6 个月时平均反转 FACIT-F 评分为 29.1（95%CI 22.7，35.5），基线时为 32.0（95%CI 31.7，32.3）。EQ-5D-5L 评分在基线（0.63，95%CI 0.62，0.64）和 6 个月（0.64，95%CI 0.59，0.69）之间相对稳定。6 个月时与长期新冠相关的每位患者的每月社会成本为 931 英镑，主要由工作天数损失相关的成本驱动。