Sex differences and rehabilitation needs after hospital discharge for COVID-19: an Italian cross-sectional study

Objectives COVID-19 can result in persistent symptoms leaving potential rehabilitation needs unmet. This study aims to describe persistent symptoms and health status of individuals hospitalised for COVID-19 according to the International Classification of Functioning, Disability and Health domains o...

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Main Authors: Luca Braglia, Monica Denti, Stefania Fugazzaro, Stefania Costi, Carlotta Mainini, Monia Allisen Accogli, Ginevra Bedogni, Daniele Ghizzoni, Anna Bertolini, Otmen Esseroukh, Cecilia Gualdi, Margherita Schiavi
Format: Article
Language:English
Published: BMJ Publishing Group 2022-05-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/12/5/e055308.full
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author Luca Braglia
Monica Denti
Stefania Fugazzaro
Stefania Costi
Carlotta Mainini
Monia Allisen Accogli
Ginevra Bedogni
Daniele Ghizzoni
Anna Bertolini
Otmen Esseroukh
Cecilia Gualdi
Margherita Schiavi
author_facet Luca Braglia
Monica Denti
Stefania Fugazzaro
Stefania Costi
Carlotta Mainini
Monia Allisen Accogli
Ginevra Bedogni
Daniele Ghizzoni
Anna Bertolini
Otmen Esseroukh
Cecilia Gualdi
Margherita Schiavi
author_sort Luca Braglia
collection DOAJ
description Objectives COVID-19 can result in persistent symptoms leaving potential rehabilitation needs unmet. This study aims to describe persistent symptoms and health status of individuals hospitalised for COVID-19 according to the International Classification of Functioning, Disability and Health domains of impairments, limitations in activity, and participation restrictions.Design Cross-sectional study consisting in a telephone interview 3 months after hospital discharge.Setting This study was conducted during the first peak of the COVID-19 pandemic by the Local Health Authority of Reggio Emilia (Italy).Participants Adult individuals discharged from hospital between April and June 2020 after COVID-19. Exclusion criteria: hospitalisation for reasons other than COVID-19, inability to participate in the study, concomitant acute or chronic conditions causing disability.Primary and secondary outcome measures We assessed: dyspnoea (Medical Research Council), fatigue (Fatigue Severity Scale), mood disturbances (Hospital Anxiety and Depression Scale), limitations in activity (Barthel Index) and participation restrictions (Reintegration to Normal Living Index). We also collected data on sociodemographic characteristics, health status prior to COVID-19, COVID-related clinical manifestations and hospital care pathway up to discharge, rehabilitation interventions, accidental falls and emergency room access.Results 149 participants (men, 62%; average age 62 (±11) years) were enrolled, 35 of which (23%) were admitted to the intensive care unit (ICU) while hospitalised. Three months after hospital discharge, nearly half of the participants still suffered from dyspnoea (44%) or fatigue (39%). Almost all individuals (91.2%) recovered a good level of independence in activity of daily living, but 76% still suffered participation restrictions. Female sex was significantly associated with worse outcomes for all symptoms.Conclusions Individuals who had moderate or severe COVID-19 may perceive persistent symptoms which may result in reduced social participation. Sex differences should be monitored, as women may recover more slowly than men.Trial registration number NCT04438239.
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spelling doaj-art-2bee5ce16f2344849831d039b3db0fc42025-08-20T01:47:51ZengBMJ Publishing GroupBMJ Open2044-60552022-05-0112510.1136/bmjopen-2021-055308Sex differences and rehabilitation needs after hospital discharge for COVID-19: an Italian cross-sectional studyLuca Braglia0Monica Denti1Stefania Fugazzaro2Stefania Costi3Carlotta Mainini4Monia Allisen Accogli5Ginevra Bedogni6Daniele Ghizzoni7Anna Bertolini8Otmen Esseroukh9Cecilia Gualdi10Margherita Schiavi11Research and Statistic Infrastructure, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, ItalyPhysical Medicine and Rehabilitation Unit, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, ItalyPhysical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale - IRCCS Tecnologie Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia, Reggio Emilia, ItalyDepartment of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, ItalyPhysical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale - IRCCS Tecnologie Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia, Reggio Emilia, ItalyPhysical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale - IRCCS Tecnologie Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia, Reggio Emilia, ItalyPhysical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale - IRCCS Tecnologie Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia, Reggio Emilia, ItalyPhysiotherapy Service, Private Hospital Villa Verde Srl, Reggio Emilia, ItalyDepartment of Medical and Sugical Sciences;University of Modena e Reggio, Bachelor` degree in OT, Modena e Reggio Emilia, ItalyDepartment of Surgery, Medicine, DentristY and Morphological Sciences; University of Modena e Reggio Emilia, Bachelor`s degree PT, Modena e Reggio Emilia, ItalyDepartment of Surgery, Medicine, DentristY and Morphological Sciences; University of Modena e Reggio Emilia, Bachelor`s degree PT, Modena e Reggio Emilia, ItalyUniversity of Modena and Reggio Emilia, Occupational Therapy, Modena, ItalyObjectives COVID-19 can result in persistent symptoms leaving potential rehabilitation needs unmet. This study aims to describe persistent symptoms and health status of individuals hospitalised for COVID-19 according to the International Classification of Functioning, Disability and Health domains of impairments, limitations in activity, and participation restrictions.Design Cross-sectional study consisting in a telephone interview 3 months after hospital discharge.Setting This study was conducted during the first peak of the COVID-19 pandemic by the Local Health Authority of Reggio Emilia (Italy).Participants Adult individuals discharged from hospital between April and June 2020 after COVID-19. Exclusion criteria: hospitalisation for reasons other than COVID-19, inability to participate in the study, concomitant acute or chronic conditions causing disability.Primary and secondary outcome measures We assessed: dyspnoea (Medical Research Council), fatigue (Fatigue Severity Scale), mood disturbances (Hospital Anxiety and Depression Scale), limitations in activity (Barthel Index) and participation restrictions (Reintegration to Normal Living Index). We also collected data on sociodemographic characteristics, health status prior to COVID-19, COVID-related clinical manifestations and hospital care pathway up to discharge, rehabilitation interventions, accidental falls and emergency room access.Results 149 participants (men, 62%; average age 62 (±11) years) were enrolled, 35 of which (23%) were admitted to the intensive care unit (ICU) while hospitalised. Three months after hospital discharge, nearly half of the participants still suffered from dyspnoea (44%) or fatigue (39%). Almost all individuals (91.2%) recovered a good level of independence in activity of daily living, but 76% still suffered participation restrictions. Female sex was significantly associated with worse outcomes for all symptoms.Conclusions Individuals who had moderate or severe COVID-19 may perceive persistent symptoms which may result in reduced social participation. Sex differences should be monitored, as women may recover more slowly than men.Trial registration number NCT04438239.https://bmjopen.bmj.com/content/12/5/e055308.full
spellingShingle Luca Braglia
Monica Denti
Stefania Fugazzaro
Stefania Costi
Carlotta Mainini
Monia Allisen Accogli
Ginevra Bedogni
Daniele Ghizzoni
Anna Bertolini
Otmen Esseroukh
Cecilia Gualdi
Margherita Schiavi
Sex differences and rehabilitation needs after hospital discharge for COVID-19: an Italian cross-sectional study
BMJ Open
title Sex differences and rehabilitation needs after hospital discharge for COVID-19: an Italian cross-sectional study
title_full Sex differences and rehabilitation needs after hospital discharge for COVID-19: an Italian cross-sectional study
title_fullStr Sex differences and rehabilitation needs after hospital discharge for COVID-19: an Italian cross-sectional study
title_full_unstemmed Sex differences and rehabilitation needs after hospital discharge for COVID-19: an Italian cross-sectional study
title_short Sex differences and rehabilitation needs after hospital discharge for COVID-19: an Italian cross-sectional study
title_sort sex differences and rehabilitation needs after hospital discharge for covid 19 an italian cross sectional study
url https://bmjopen.bmj.com/content/12/5/e055308.full
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