Data_Sheet_1_15-Month Health Outcomes and the Related Risk Factors of Hospitalized COVID-19 Patients From Onset: A Cohort Study.docx

ObjectiveThe long-term impact of COVID-19 on patient health has been a recent focus. This study aims to determine the persistent symptoms and psychological conditions of patients hospitalized with COVID-19 15 months after onset, that patients first developed symptoms. The potential risk factors were also explored.
MethodsA cohort of COVID-19 patients discharged from February 20, 2020 to March 31, 2020 was recruited. Follow-ups were conducted using validated questionnaires and psychological screening scales at 15 months after onset to evaluate the patients' health status. The risk factors for long-term health impacts and their associations with disease severity was analyzed.
Findings534 COVID-19 patients were enrolled. The median age of the patients was 62.0 years old (IQR 52.0–70.0) and 295 were female (55.2%). The median time from onset to follow-up was 460.0 (451.0–467.0) days. Sleep disturbance (18.5%, 99/534) and fatigue (17.2%, 92/534) were the most common persistent symptoms. 6.4% (34/534) of the patients had depression, 9.2% (49/534) were anxious, 13.0% (70/534) had insomnia and 4.7% (25/534) suffered from post-traumatic stress disorder (PTSD). Multivariate adjusted logistic regression analysis showed that glucocorticoid use during hospitalization (OR 3.58, 95% CI 1.12–11.44) was significantly associated with an increased risk of fatigue. The OR values for anxiety and sleep disorders were 2.36 (95% CI 1.07–5.20) and 2.16 (95% CI 1.13–4.14) in females to males. The OR value of PTSD was 25.6 (95% CI 3.3–198.4) in patients with persistent symptoms to those without persistent symptoms. No significant associations were observed between fatigue syndrome or adverse mental outcomes and disease severity.
Conclusions15-month follow-up in this study demonstrated the need of extended rehabilitation intervention for complete recovery in COVID-19 patients.

研究目的：新冠疫情对患者健康的长期影响是近期的研究热点。本研究旨在明确患者首次出现症状后15个月时，曾因新冠住院的患者的持续症状与心理状况，并探索潜在的风险因素。
研究方法：本研究招募了2020年2月20日至2020年3月31日期间出院的新冠患者队列。在患者发病后15个月时，采用经过信效度验证的问卷与心理筛查量表开展随访，以评估患者的健康状态，并分析长期健康影响的风险因素及其与疾病严重程度的关联。
研究结果：本研究共纳入534例新冠患者。患者的中位年龄为62.0岁（四分位间距Interquartile Range, IQR：52.0~70.0），其中女性295例，占比55.2%。从发病至随访的中位时间为460.0（451.0~467.0）天。睡眠障碍（18.5%，99/534）与疲劳（17.2%，92/534）是最常见的持续症状。6.4%（34/534）的患者存在抑郁症状，9.2%（49/534）存在焦虑症状，13.0%（70/534）存在失眠，4.7%（25/534）罹患创伤后应激障碍（post-traumatic stress disorder, PTSD）。多变量校正logistic回归分析显示，住院期间使用糖皮质激素（比值比Odds Ratio, OR：3.58，95%置信区间Confidence Interval, CI：1.12~11.44）与疲劳风险升高显著相关。女性相较于男性，焦虑与睡眠障碍的OR值分别为2.36（95%CI：1.07~5.20）与2.16（95%CI：1.13~4.14）。存在持续症状的患者相较于无持续症状者，创伤后应激障碍的OR值为25.6（95%CI：3.3~198.4）。未观察到疲劳综合征或不良心理结局与疾病严重程度存在显著关联。
研究结论：本研究通过15个月的随访结果证实，新冠患者需接受长期康复干预以实现完全康复。