Covid worsens the quality of life in half of patients who were hospitalized

New research has found that Covid-19 is associated with worsening quality of life due to sequelae in more than half of patients who have been hospitalized for the disease. Female gender and advanced age were the aspects that were most associated with the development of mental or physical problems even months after hospital discharge.

The study was signed by researchers at the Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), in Minas Gerais, and published in the Journal of the Brazilian Society of Tropical Medicine. It also had the collaboration of UFMG (Federal University of Minas Gerais) and Fiocruz (Fundação Oswaldo Cruz).

Long-term Covid – as the chronic health problems resulting from an infection with Sars-CoV-2 are called – has been investigated around the world. In Brazil, initiatives for the treatment of loss of smell or the use of cannabis for the condition are some examples.

One of the authors of the study and professor in the physiotherapy department at UFVJM, Henrique Costa, says that the idea of ​​carrying out the investigation came when residents observed “that post-Covid patients treated [em unidades básicas de saúde] reported problems months after hospital discharge”.

“The objective was to identify which factors were associated with the worse quality of life of these patients, because if we can identify these aspects, we can design a more effective intervention”, completes the author.

The investigation consisted of a systematic review — when other published studies are used to understand what has been produced so far on the subject. In this case, six databases were used, which initially resulted in more than 4,000 articles. In the end, 24 met the requirements of the theme defined by the group of researchers.

“It is common to have a high initial number, but a low final number. In this case, the objective was very specific. For example, we found studies that evaluated quality of life, but in outpatients [e por isso não entrou]”, explains Costa.

This example article was removed from the study because the researchers only investigated patients who had been hospitalized — either on mechanical ventilation or in the ward — with a Covid infection.

From there, they observed what the literature had already been discussing on the subject. “The studies we found followed up patients after they had Covid that ranged from 15 days to 6 months after hospital discharge”, he says.

On average, it was observed that 15% to 56% of patients in the total sample of the 24 articles that made up the review reported problems after being cured of the infection.

Costa explains that these sequels were divided into categories. For example, some of the remaining problems were of a physical nature and the most reported were pain and discomfort, especially in the thoracic and joint regions and generalized myalgia.

“To explain this effect, there are multiple causes, as a consequence of viral infection in the peripheral neuromuscular system”, explains the professor.

Other sequelae that worsened the patients’ quality of life were mental and were mainly anxiety, depression, post-traumatic stress and fear of reinfection.

In addition to identifying those problems that were the most persistent in the case of these patients who were hospitalized for Covid-19, the study wanted to understand which aspects were most associated with these conditions that continued in these people – the main ones being female and old age.

“About females, the literature has already shown that, in men, the disease usually presents itself in a more severe form and even with a greater probability of death. However, women, it is not known why, have a very negative experience of the disease. presence of symptoms in the long term”, he says.

In relation to advanced age, scientific research has shown that this factor is associated with a slower recovery of physical and mental health, which explains the continuity of sequelae in this part of the population.

In addition to these two factors, the researchers also found others related to the presence of sequelae, such as length of hospital stay, duration of invasive mechanical ventilation, presence of kidney disease, history of smoking and obesity. These points, however, are not completely consolidated, unlike the case of females and advanced age.

Although the study did not directly involve the patients seen by the researchers, Costa states that the sequelae observed in the articles that composed the systematic review are similar to the complaints seen in the UBS, especially anxiety and depression.

The idea of ​​the research is that, by identifying these conditions that persist together with the factors associated with them, there is the possibility of developing health strategies to improve the quality of life of these patients who are more susceptible to persistent problems.

“The applicability of the study is very clinical in the sense of recognizing patients who are most vulnerable and directing some specific actions for them”, concludes Costa.