RESUMO
OBJECTIVES: To determine the health status, exercise capacity, and health related quality of life (HRQoL) of COVID-19 associated acute respiratory distress syndrome (ARDS) survivors, 8 months after diagnosis. METHODS: All eligible patients were interviewed and underwent a physical examination, chest X-ray, and 6 min walk test (6MWT). Scales to evaluate post-traumatic stress disorder, depression, anxiety, and HRQoL were applied. RESULTS: Of 1295 patients, 365 suffered ARDS and 166 survived to hospital discharge. Five died after discharge and 48 were lost to follow-up. Of the 113 remaining patients, 81% had persistent symptoms. More than 50% of patients completed less than 80% of the theoretical distance on the 6MWT, 50% had an abnormal X-ray and 93% of patients developed psychiatric disorders. Mean SF-36 scores were worse than in the general population. After multivariate regression analysis, female sex, non-Caucasian race, and Charlson index>2 were independent risk factors for a worse mental health component summary score on the SF-36, and age was associated with a better prognosis. Female sex and chronic obstructive pulmonary disease were independently associated with a worse physical component summary score. CONCLUSION: COVID-19 associated ARDS survivors have long-term consequences in health status, exercise capacity, and HRQoL. Strategies addressed to prevent these sequelae are needed.
Assuntos
COVID-19 , Síndrome do Desconforto Respiratório , Feminino , Humanos , Qualidade de Vida , Síndrome do Desconforto Respiratório/epidemiologia , SARS-CoV-2 , SobreviventesRESUMO
Los pacientes con artritis reumatoide (AR) tratados con fármacos modificadores del curso de la enfermedad están expuestos a desarrollar infecciones potencialmente graves como la leishmaniasis. L. infantum es endémica en el Mediterráneo, hecho que obliga ante un paciente con AR que presenta fiebre y pancitopenia, a descartar este proceso. Un diagnóstico de sospecha precoz, puede evitar un curso y pronóstico fatal (AU)
Patients with rheumatoid arthritis (RA) treated with disease-modifying antirheumatic drugs are susceptible to severe infections such as leishmaniasis. As L. infantum is endemic in the Mediterranean region, it is necessary to rule this infectious process out in any RA patient presenting with fever and pancytopenia. An early diagnosis based on a high suspicion can prevent a fatal outcome (AU)
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Leishmaniose Visceral/complicações , Artrite Reumatoide/tratamento farmacológico , Metotrexato/uso terapêutico , Hidroxicloroquina/administração & dosagem , Glucocorticoides/administração & dosagem , Anfotericina B/administração & dosagem , Prognóstico , Comorbidade , Diagnóstico Diferencial , Diagnóstico PrecoceRESUMO
Patients with rheumatoid arthritis (RA) treated with disease-modifying antirheumatic drugs are susceptible to severe infections such as leishmaniasis. As L. infantum is endemic in the Mediterranean region, it is necessary to rule this infectious process out in any RA patient presenting with fever and pancytopenia. An early diagnosis based on a high suspicion can prevent a fatal outcome.
Assuntos
Artrite Reumatoide/complicações , Imunossupressores/efeitos adversos , Leishmaniose Visceral/etiologia , Metotrexato/efeitos adversos , Anfotericina B/uso terapêutico , Antiprotozoários/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Suscetibilidade a Doenças , Diagnóstico Precoce , Feminino , Humanos , Hospedeiro Imunocomprometido , Imunossupressores/uso terapêutico , Indometacina/uso terapêutico , Leishmaniose Visceral/diagnóstico , Leishmaniose Visceral/tratamento farmacológico , Metotrexato/uso terapêutico , Pessoa de Meia-Idade , Pancitopenia/induzido quimicamente , Prednisona/efeitos adversos , Prednisona/uso terapêuticoRESUMO
No disponible