关键词:
Pulmonary Embolism
COVID-19
Quality of Life
Respiratory Function Tests
CFQ
Cognitive Failure Questionnaire
COVID-19
Coronavirus Disease 2019
CTEPH
Chronic Thromboembolic Pulmonary Hypertension
DLCO
Diffusing Capacity of the Lungs for Carbon monoxide
EQ-5D-5L
5-level EuroQol 5D questionnaire
FEV
1
Forced Expiratory Volume in 1 s
FVC
Forced Vital Capacity
GAD-7
Generalized Anxiety Disorder
GGO
Ground-Glass Opacities
HADS
Hospital Anxiety and Depression Scale
HRQoL
Health-Related Quality of Life
ICU
Intensive Care Unit
IES-R
Impact of Event Scale-Revised
IRQ
Interquartile range
LLN
Lower Limit of Normal
PE
Pulmonary Embolism
PHQ
Patient Health Questionnaire-9
PROMs
Patient Reported Outcome Measures
PTSD
Post-Traumatic Stress Disorder
SARS-COV-2
Severe Acute Respiratory Syndrome Coronavirus 2
SD
Standard Deviation
UMC
University Medical Center
VAS
Visual Analogue Scale
VTE
Venous thromboembolism
摘要:
Background COVID-19 patients frequently experience pulmonary embolism (PE), but its long-term consequences remain uncertain. Research question What is the impact of PE in COVID-19 patients on health outcomes at 3 months post-hospitalization? Study design and methods In this multicenter cross-sectional study, we aggregated data from existing databases to evaluate the impact of PE on health outcomes at 3 months post-hospitalization. We assessed 1) questionnaires on health-related quality of life (HRQoL, EQ-5D-5L questionnaire), anxiety, depression, cognitive failure, and post-traumatic stress disorder (PTSD), 2) pulmonary function tests (diffusing capacity of the lungs for carbon monoxide (DLCO) and spirometry), and 3) radiological abnormalities. We developed three models to assess the association between PE and the EQ-5D-5L index and the percentage of predicted DLCO (DLCO%): a crude model (model 1), adjusted for age, sex, and presence of comorbidities (model 2), and model 2 additionally adjusted for intensive care unit (ICU) admission (model 3). Results We included 465 patients that had been hospitalized for COVID-19, of whom 102 (21.9%) had developed a PE during admission. Patients with PE had poorer EQ-5D-5L index values, more impairment in pulmonary functions, and more frequently radiological abnormalities than patients without PE. Symptoms of anxiety, depression, cognitive failure, and PTSD did not differ between the two groups. In model 2, PE was associated with lower EQ-5D-5L index and lower DLCO%. After additionally adjusting for ICU admission, the association between PE and lower EQ-5D-5L index (mean difference (MD) =-0.069, (95%CI -0.12 to -0.017) remained, but not between PE and DLCO%. Interpretation Our findings suggest that PE in COVID-19 patients is associated with reduced HRQoL at 3 months post-hospitalization. While PE may be a marker of COVID-19 severity, its presence during hospitalization could indicate potential long-term health issues, which may b