Preditores da COVID-19 Longa e o seu Impacto na Qualidade de Vida: Análise Longitudinal aos 3, 6 e 9 Meses após a Alta de um Centro Português
DOI:
https://doi.org/10.20344/amp.19047Palavras-chave:
COVID-19, Portugal, Qualidade de Vida, Síndrome Pós-COVID-19Resumo
Introdução: Os dados referentes ao efeito da COVID-19 longa na qualidade de vida relacionada com a saúde (QV-RS) são escassos. O objetivo deste estudo foi descrever prospectivamente a prevalência e os fatores de risco associados à COVID-19 longa após a alta hospitalar e avaliar o seu impacto na QV-RS.
Métodos: Estudo longitudinal unicêntrico incluindo todos os doentes com COVID-19 com alta hospitalar entre dezembro de 2020 e fevereiro de 2021. Os doentes foram contactados telefonicamente aos três, seis e nove meses. Os dados foram colhidos da seguinte forma: 1) autorrelato dos sintomas associados à COVID-19 longa; 2) avaliação da QV-RS através do questionário de três níveis EuroQoL-5D (EQ-5D-3L). Excluímos grávidas, doentes dementes, acamados e não-falantes de português.
Resultados: Cento e cinquenta e dois, 117 e 110 doentes foram avaliados aos três, seis e nove meses (idade mediana: 61 anos; homens: 56,6%). A COVID-19 longa (≥ 1 sintoma) estava presente em 66,5%, 62,4% e 53,6% dos doentes, e 65,8%, 69,2% e 55,4% descreveram compromisso da QV-RS (≥ 1 domínio) aos três, seis e nove meses, respetivamente. O sintoma persistente mais comum foi a fadiga. O domínio ansiedade/depressão foi o mais afetado nos três momentos, com pico aos seis meses (39%), seguido pelos domínios dor/desconforto e mobilidade. A COVID-19 longa associou-se ao compromisso de todos os domínios da EQ-5D-3L, exceto ao do autocuidado. Nem a admissão nos cuidados intensivos nem a gravidade da doença se associou à COVID-19 longa nem ao compromisso de qualquer domínio da EQ-5D-3L. A COVID-19 longa permaneceu significativamente associado à diminuição da QV-RS aos três (OR 4,27, IC 95% 1,92 – 9,52, p < 0,001), seis (OR 3,46, IC 95% 1,40 – 8,57, p = 0,007) e nove meses (OR 4,13, IC 95% 1,62 – 10,55, p = 0,003) após ajuste para o sexo, idade, grau de autonomia e comorbilidades. Na análise longitudinal, o índice EQ-5D-3L estava diminuído em 0,14/visita (p < 0,001) nos doentes com COVID-19 longa aos três meses em comparação com os assintomáticos, e ambos os grupos mostraram uma variação não significativa do índice EQ-5D-3L durante os nove meses do estudo (Z = 0,91, p = 0,364).
Conclusão: As sequelas clínicas associadas à COVID-19 longa podem persistir por pelo menos nove meses após a alta hospitalar e podem comprometer a QV-RS a longo prazo em mais da metade dos doentes, independentemente da gravidade da doença e das características clinicodemográficas.
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