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Prevalence and risk factors of disability and anxiety in a retrospective cohort of 432 survivors of Coronavirus Disease-2019 (Covid19) from China
Zhu, Siyi; Gao, Qiang; Yang, Lin [u. a.]
Public Library of Science - PLoS
PLoS One, 2020, Volume 15 (Issue 12), San Francisco, Californien: Eigenverlag, Online-Ressource, ISSN: 1932-6203 (Online)
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To estimate the prevalence of disability and anxiety in Covid-19 survivors at discharge from hospital and analyze relative risk by exposures.
Multi-center retrospective cohort study.
Twenty-eight hospitals located in eight provinces of China.
A total of 432 survivors with laboratory-confirmed SARS CoV-2 infection participated in this study. At discharge, we assessed instrumental activities of daily living (IADL) with Lawton's IADL scale, dependence in activities of daily living (ADL) with the Barthel Index, and anxiety with Zung's self-reported anxiety scale. Exposures included comorbidity, smoking, setting (Hubei vs. others), disease severity, symptoms, and length of hospital stay. Other risk factors considered were age, gender, and ethnicity (Han vs. Tibetan).
Prevalence of at least one IADL problem was 36.81 percent (95 percent CI: 32.39-41.46). ADL dependence was present in 16.44 percent (95 percent CI: 13.23-20.23) and 28.70 percent (95 percent CI: 24.63-33.15) were screened positive for clinical anxiety. Adjusted risk ratio (RR) of IADL limitations (RR 2.48, 95 percent CI: 1.80-3.40), ADL dependence (RR 2.07, 95 percent CI 1.15-3.76), and probable clinical anxiety (RR 2.53, 95 percent CI 1.69-3.79) were consistently elevated in survivors with severe Covid-19. Age was an additional independent risk factor for IADL limitations and ADL dependence; and setting (Hubei) for IADL limitations and anxiety. Tibetan ethnicity was a protective factor for anxiety but a risk factor for IADL limitations.
A significant proportion of Covid-19 survivors had disability and anxiety at discharge from hospital. Health systems need to be prepared for an additional burden resulting from rehabilitation needs of Covid-19 survivors.
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