Supplementary Material for: Impact of Confinement in Patients under Long-Term Noninvasive Ventilation during the First Wave of the SARS-CoV-2 Pandemic: A Remarkable Resilience

Background: During the first wave of the SARS-CoV-2 pandemic in Switzerland, confinement was imposed to limit transmission and protect vulnerable persons. These measures may have had a negative impact on perceived quality of care and symptoms in patients with chronic disorders. Objectives: To determine whether patients under long-term home noninvasive ventilation (LTHNIV) for chronic respiratory failure (CRF) were negatively affected by the 56-day confinement (March–April 2020). Methods: A questionnaire-based survey exploring mood disturbances (HAD), symptom scores related to NIV (S3-NIV), and perception of health-care providers during confinement was sent to all patients under LTHNIV followed up by our center. Symptom scores and data obtained by ventilator software were compared between confinement and the 56 days prior to confinement. Results: Of a total of 100 eligible patients, 66 were included (median age: 66 years [IQR: 53–74]): 35 (53%) with restrictive lung disorders, 20 (30%) with OHS or SRBD, and 11 (17%) with COPD or overlap syndrome. Prevalence of anxiety (n = 7; 11%) and depressive (n = 2; 3%) disorders was remarkably low. Symptom scores were slightly higher during confinement although this difference was not clinically relevant. Technical data regarding ventilation, including compliance, did not change. Patients complained of isolation and lack of social contact. They felt supported by their relatives and caregivers but complained of the lack of regular contact and information by health-care professionals. Conclusions: Patients under LTHNIV for CRF showed a remarkable resilience during the SARS-CoV-2 confinement period. Comments provided may be helpful for managing similar future health-care crises.

背景：在严重急性呼吸综合征冠状病毒2（SARS-CoV-2）疫情瑞士第一波流行期间，当地实施封控措施以限制病毒传播、保护易感人群。此类防疫举措或对慢性疾病患者的感知照护质量及临床症状产生负面影响。

研究目的：明确因慢性呼吸衰竭（chronic respiratory failure, CRF）接受长期家庭无创通气（long-term home noninvasive ventilation, LTHNIV）治疗的患者，是否在2020年3-4月为期56天的封控期间受到负面影响。

方法：本研究向本中心随访的所有接受LTHNIV治疗的患者发放基于问卷的调研，内容涵盖封控期间的情绪障碍评估（医院焦虑抑郁量表, Hospital Anxiety and Depression Scale, HAD）、无创通气（noninvasive ventilation, NIV）相关症状评分（S3-NIV）以及对医疗服务提供者的感知情况。研究对比了封控期间与封控前56天的症状评分及呼吸机软件获取的通气相关数据。

结果：本研究共纳入100名符合入组标准的患者中的66例，患者中位年龄为66岁[四分位间距（Interquartile Range, IQR）：53~74岁]；其中35例（53%）为限制性肺疾病患者，20例（30%）为肥胖低通气综合征（Obesity Hypoventilation Syndrome, OHS）或睡眠相关呼吸障碍（Sleep-Related Breathing Disorders, SRBD）患者，11例（17%）为慢性阻塞性肺疾病（Chronic Obstructive Pulmonary Disease, COPD）或重叠综合征患者。焦虑障碍（n=7；11%）与抑郁障碍（n=2；3%）的患病率极低。封控期间的症状评分略高于封控前，但该差异无临床意义。包括通气顺应性在内的通气相关技术参数未发生明显变化。患者主诉存在孤立感与社交接触缺失的问题，他们感受到了亲属及照护者的支持，但对医疗专业人员缺乏定期沟通与信息告知表示不满。

结论：因慢性呼吸衰竭接受LTHNIV治疗的患者，在SARS-CoV-2封控期间表现出显著的心理韧性。本研究所得的相关见解可为未来应对类似公共卫生危机提供参考。