Dugoročni ishodi bolesti u bolesnika s COVID-19 bolesti liječenih u jedinici intenzivnog liječenja Klinike za infektivne bolesti "Dr. Fran Mihaljević"

master's thesis

• Title (english): Long term outcomes in patients with COVID-19 treated in intensive care unit at the University Hospital for Infectious Diseases "Dr. Fran Mihaljević"
• Author: Elizabeta Skočibušić
• Mentor: Vladimir Krajinović (mentor)
• Committee member: Marko Kutleša (predsjednik povjerenstva)
• Committee member: Goran Tešović (član povjerenstva)
• Committee member: Vladimir Krajinović (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Infectious Diseases); Zagreb
• Defense date and country: 2022-09-20, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Infectology

Abstract

Uvod: Pandemija koronavirusne bolesti 2019 (COVID-19) uzrokovana SARS-CoV-2 virusom započela je krajem 2019. godine u Kini i donijela je brojne izazove kako u liječenju akutne bolesti, tako i u liječenju njezinih dugoročnih posljedica. U bolesnika koji su imali teški oblik COVID-19 i boravili u jedinici intenzivnog liječenja (JIL), sa simptomima zaostalima nakon preboljenja COVID-a preklapaju se i tegobe koje se javljaju u sklopu sindroma postintenzivne skrbi. Cilj je ovoga rada ispitati tegobe zaostale u bolesnika nakon liječenja teškog oblika COVID-19 u JIL-u.
----- Ispitanici i metode: U istraživanju je sudjelovalo 88 bolesnika koji su uslijed teškog oblika COVID-19 bili liječeni u JIL-u. Pomoću telefonske ankete ispitana su pitanja koja su preuzeta i prilagođena iz 15D upitnika kako bi se procijenila promjena u pojedinim dimenzijama nakon boravka u JIL-u u odnosu na stanje prije bolesti. Podaci o bolesnicimai njihovom liječenju prikupljeni su iz bolničke dokumentacije. Podaci su analizirani metodama deskriptivne statistike, a Spearmanova korelacija korištena je za procjenu potencijalne korelacije među varijablama.
----- Rezultati: U istraživanje je ukupno uključeno 88 ispitanika, većinom muškarci (N=63, 71.6%). 80.7% ispitanika prijavilo je barem jednu poteškoću u trenutku provođenja ankete koja nije bila prisutna prije boravka u JIL-u. Najčešće su to bile poteškoće u dimenziji disanja (N=52, 59.1%), pokretljivosti (N=38, 43.2%), mentalne funkcije (N=32, 36.4%) te svakodnevne aktivnosti (N=24, 27.3%). Na uzorku ispitanika u ovom istraživanju nije uočena značajna korelacija između dobi, Charlsonina indeksa (CCI), duljine hospitalizacije, boravka u JIL-u ili na mehaničkoj ventilaciji i promjena u pojedinim dimenzijama. Pronađena je blaga pozitivna korelacija među dimenzijama disanja i svakodnevne aktivnosti (Spearmanov ρ 0.265; p=0.013) te disanja i mentalne aktivnosti (Spearmanov ρ 0.272; p=0.011).
----- Zaključak: U većine pacijenata koji su boravili u JIL-u uslijed teškog oblika COVID-19 bolesti, tegobe u fizičkom, kognitivnom i mentalnom funkcioniranju prisutne su mjesecima nakon otpusta i utječu na kvalitetu života tih pacijenata.

Abstract (english)

Introduction: COVID-19 pandemic, caused by SARS-COV-2 virus, began in China at the end of the 2019, and brought many challenges both in treatment of the acute disease and of its long-term consequences. In patients treated in the ICU for severe form of COVID-19, symptoms that persist after the disease itself overlap with symptoms of post-intensive care syndrome. The aim of this study is to examine the persisting complaints after being treated in the ICU for COVID-19.
----- Participants and methods: 88 participants that were previously treated in the ICU were included in this study. A telephone survey using modified questions from the 15D questionnaire was performed in order to assess the change of patient’s symptoms after ICU treatment in comparison to their previous state. Information regarding patients and their treatment was gathered from hospital documentation. Data was analyzed using methods of descriptive statistics and Spearman's correlation was used in order to assess potential correlation between variables.
----- Results: Total of 88 participants were included in this study, mostly male (N=63, 71.6%). 80.7% of participants reported at least one complaint at the moment of the survey which was not present before ICU stay. Most common complaints were difficulties in the following dimensions: breathing (N=52, 59.1%), mobility (N=38, 43.2%), mental function (N=32, 36.4%), and usual activities (N=24, 27.3%). No significant correlation between age, CCI, length of hospitalization, length of stay in the ICU or mechanical ventilation and changes in individual dimensions were found. A slightly positive correlation (Spearman's ρ: 0.265; p=0.013) was found between the dimensions of breathing and daily activity and breathing and mental activity (Spearman's ρ 0.272; p=0.011).
----- Conclusion: In most patients treated in the ICU due to severe form of COVID-19, physical, cognitive and mental symptoms are present months after discharge, and they affect their quality of life.

• Keywords: COVID-19; jedinica intenzivnog liječenja; sindrom postintenzivne skrbi; post-covid
• Keywords (english): COVID-19; intensive care unit; post-intensive care syndrome; post-covid
• Language: croatian
• URN:NBN: urn:nbn:hr:105:624254
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-02-15 12:36:48